Risks and causes of Hodgkin's lymphoma
This page tells you about the possible risks and causes of Hodgkin's lymphoma. There is information about
Risks and causes of Hodgkin’s lymphoma
We don't know exactly what causes Hodgkin’s lymphoma. Most people who develop Hodgkin's lymphoma do not have any particular risk factors. But there are a few things that may make some people more likely to get it.
Age and gender
The peak age for Hodgkin’s lymphoma is 15 to 29. It is the 3rd most common cancer in this age group. It then becomes less common until older age, when the number of cases increases again. It is slightly more common in men than in women.
Lowered immunity
Anyone whose immune system is not working properly may be more likely to develop a lymphoma. This includes people who are taking drugs to stop organ rejection after a transplant, people who have HIV or AIDS, people born with rare medical syndromes that affect immunity, and people who develop 'autoimmune' conditions, such as rheumatoid arthritis or lupus (SLE).
There are other risk factors that have been investigated, but there is no strong evidence for any of them.
Hodgkin's lymphoma used to be called Hodgkin's disease. It is not very common. About 1,600 cases are diagnosed in the UK each year. About 1 in every 200 cancers diagnosed is a Hodgkin's lymphoma. It is much less common than non Hodgkin's lymphoma, which is diagnosed in about 10,500 people each year.
We don't know what causes Hodgkin's lymphoma but there are several risk factors.
A risk factor is anything that can increase your chance of developing cancer. Do bear in mind that having one or more risk factors does not necessarily mean that you will get Hodgkin's lymphoma. In fact, most people who develop Hodgkin's lymphoma do not have any particular risk factors. We don't know exactly what causes it. But some people may be more likely to develop it.
Hodgkin's lymphoma can occur at any age, although it is rare. It becomes more common in the teens. There is a peak between 15 and 29 years old. Hodgkin's lymphoma is the 3rd most common cancer in this age group. It then becomes less common until older age, when the number of cases increases again. Hodgkin's lymphoma is slightly more common in men than in women.
Anyone whose immune system is not working properly is more likely to develop a lymphoma. The immune system fights disease. You may have low immunity if you
- Are taking medicines to stop organ rejection after a transplant
- Have AIDS
- Were born with a rare medical syndrome that affects immunity
- Develop an 'autoimmune' condition, such as rheumatoid arthritis or systemic lupus erythematosus (SLE)
People with HIV or AIDS have a risk of Hodgkin’s lymphoma that is 11 times higher than the average risk. People who have had an organ transplant are 4 times more likely to develop Hodgkin's lymphoma than other people in the population.
We don't know whether the increased risk in people with autoimmune disease comes from the drugs people have to take, from the autoimmune conditions themselves, or whether there are common factors that can cause both the autoimmune conditions and Hodgkin's lymphoma.
There is evidence of an increased risk of Hodgkin's lymphoma in first degree relatives of people with ulcerative colitis and sarcoidosis, which may be due to a common factor.
If you live in crowded conditions, have brothers and sisters, or go to nursery, you are more likely to pick up common childhood infections early in life rather than later. A few studies show that Hodgkin’s lymphoma risk is lower in groups of people who are exposed to infections early. It may be that getting infections early helps you to develop a healthy immune system and this is what lowers the risk of Hodgkin's lymphoma.
Some types of Hodgkin's lymphoma occur more often in people who have Epstein Barr virus infection. Some research studies have found fewer cases of these types of lymphoma in young adults who had common childhood infections before they were 10. So having the common infections may have increased their resistance to Epstein Barr virus infection, and so lowered their risk of Hodgkin's lymphoma.
The picture about infections still isn’t completely clear because another study found that Hodgkin’s lymphoma was more common in areas with greater unemployment and overcrowded housing, which seems to contradict the other research findings. Other research has looked at how well off you are and whether that affected Hodgkin’s lymphoma risk, but it hasn't found any link at all.
Epstein Barr virus is the virus that causes glandular fever (mononucleosis). Glandular fever is not a serious disease, although it can last a long time. But it may very slightly increase the risk of getting Hodgkin's lymphoma afterwards. There is not a great deal of scientific evidence for this - over half of the people with Hodgkin's lymphoma show no infection with Epstein Barr. The exact role of this virus is not clear, but doctors think it could be a factor.
There is no clear cause in most cases of Hodgkin's lymphoma. Research is going on to try to find out exactly what does cause this cancer. What we do know is that, like all cancers, Hodgkin's lymphoma is not infectious. You cannot catch it from someone who has it.
An identical twin of a diagnosed Hodgkin's lymphoma patient is nearly 100 times more likely to develop it than other people in the population. But for non identical twins, there is no more risk than for any other close relative. Identical twins have the same genes and non identical twins do not. So this tells scientists that there is likely to be a faulty gene increasing the risk of developing Hodgkin's lymphoma. This isn't likely to be a major factor because there is no family history in most people diagnosed. In America, they have found that Hodgkin's is more common in white people than it is in black people. This is another piece of evidence that tells us a gene may be involved.
First degree relatives of people with Hodgkin's lymphoma have a slightly increased risk of getting Hodgkin's themselves. But this doesn't help to show whether there is a gene involved or whether it is due to shared lifestyle factors. A first degree relative is a parent, child, sister or brother.
A study combining all the results of earlier research found a lower risk of Hodgkin's lymphoma in children who had been breastfed, but we don't really know why this occurs or how important this is.
Several studies over the years have looked into hair dyes and risk of lymphomas. One paper combined all the results of earlier studies and found no link between hair dye use and risk of Hodgkin's lymphoma. Since then, another study has looked into hair dye use in several European countries. These researchers said they could see an increased risk if they combined results for all countries they looked at except Germany. This may be just a blip, or there may be some other explanation we don't have yet. Realistically, it seems that there is only likely to be a very small link, if there is one at all.
A few studies show a lower risk of Hodgkin's lymphoma in alcohol drinkers. A study published in 2007 showed a lower risk in drinkers, but not in drinkers who smoked.
A recent study reported that people exposed to pesticides in their work may have an increased risk of Hodgkin’s lymphoma.
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