Sex differences in chemotherapy-induced alopecia distress using the Japanese version of the Chemotherapy-Induced...

While chemotherapy-induced alopecia (CIA) is a concern for patients with cancer, investigations involving men with CIA are limited. We aimed to examine sex differences in chemotherapy-related distress using the Japanese version of the Chemotherapy-Induced Alopecia Distress Scale (CADS-J).

The study, conducted at Toranomon and Yokohama Minami Kyosai Hospitals between March and December 2023, employed a one-time 17-item questionnaire survey (CADS-J) for patients with cancer who had not previously experienced CIA-related hair loss. Each item was scored from 0 (none) to 3 (severe), with total scores ranging from 0 to 51.

Of 104 patients who received the questionnaire, 97 were included in the analysis (men, 55 [56.7%]; mean age, 62.6 ± 12.7 years). Metastatic disease was present in 92.7% and 50% of the men and women, respectively. Pancreatic (35%) and gastric (16%) cancers were most common in the men; while pancreatic (26%) and breast (24%) cancers were most common in the women. Common terminology criteria for adverse events (CTCAE) grade 2 CIA was observed in 70.9% and 95.2% of the men and women, respectively. Mean CADS-J total scores were: men, 5.7; women, 13.2 (p < 0.001); women scored significantly higher in every domain. In a multivariable analysis, female sex, wig or hat use, and depressive symptoms (Center for Epidemiologic Studies Depression Scale ≥ 16) were independently associated with higher CADS-J total scores. Among the men, 5/55 (9.1%) had CADS-J total scores ≥ 13 (the female mean); of whom four (80%) had CTCAE grade 2 CIA and wore a wig or hat.

To our knowledge, this is the first study to report sex differences in distress associated with CIA using CADS-J. Distress was stronger in women, but some men also experienced marked distress. Further research and clinical evaluations are needed to individualize targeted care.