The Association Between Tattoos and the Risk of Lymphoma

by | Jul 23, 2024 | 2024, Cancer, Recent Articles, Skin Health

Written by Harold Oster, MD. Results suggest that having a tattoo may be associated with an increased risk of lymphoma.

Lymphoma is a malignant neoplasm originating in lymphocytes. In the United States, more than 80,000 new cases are diagnosed annually. Lymphomas are classified into the broad categories of Hodgkin and non-Hodgkin, which includes numerous subtypes. Risk factors for lymphoma include family history, obesity, smoking, chronic inflammatory conditions, and exposure to various chemicals, notably pesticides1,2. Tattoos, created when a needle inserts ink into the dermis, have become increasingly popular in the United States and elsewhere, leading to increased concerns regarding their risks3. Tattooing triggers an immune response that translocates pigments, some of which may be carcinogenic4, to regional lymph nodes5.

Christel Nielsen et al. studied the association between tattoo exposure and the risk of developing lymphoma. The authors identified cases of lymphoma diagnosed between 2007 and 2017 by analyzing data from the Swedish National Cancer Register6. For each index case, three matched controls were randomly sampled from the Swedish National Population Register7. For the index cases, the date that the lymphoma was diagnosed was defined as the index date. In the matched controls, the same date was used. A history of a tattoo was assessed through questionnaires. Participants, or the next of kin if the participant was deceased, were questioned regarding age at first tattoo, number of tattoos, and total area of the tattooed body surface measured in hand palms. Information regarding potential confounding variables, including demographic factors, level of education, and smoking, was gathered from national databases.

The authors noted the following:

  • Based on inclusion criteria, data from 11,905 participants aged twenty to sixty was used for the study.
  • 2,938 cases of lymphoma were identified. The remainder of the participants were controls.
  • 21% of participants with lymphoma had tattoos compared with 18% of the controls.
  • After adjustment for confounding variables, tattooed participants had a higher risk of developing lymphoma. (Incidence Rate Ratio {IRR} of 1.21)
  • Participants whose first tattoo was placed less than two years before the index date were at significantly increased risk of lymphoma. (IRR of 1.81)
  • Participants whose first tattoo was placed eleven or more years before the index date were at increased risk of lymphoma. (IRR of 1.23)
  • A larger area of tattooed body surface was not associated with an increased risk of lymphoma. The highest risk was in individuals with tattoos smaller than one hand palm. (IRR of 1.27)
  • The risk associated with tattoo exposure was strongest for diffuse large B-cell non-Hodgkin lymphoma. (IRR of 1.30)

Results suggest that tattoo exposure may be associated with an increased risk of lymphoma. Limitations of the study include the use of questionnaires, possible selection bias, and the possibility of residual confounding.

Source: Nielsen, Christel, Mats Jerkeman, and Anna Saxne Jöud. “Tattoos as a risk factor for malignant lymphoma: a population-based case–control study.” EClinicalMedicine 72 (2024).

© 2024 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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Posted July 23, 2024.

Harold Oster, MD graduated from medical school in Miami, Florida in 1992 and moved to Minnesota in 2004. After more than 25 years of practicing Internal Medicine, he recently retired. Dr. Oster is especially interested in nutrition, weight management, and disease prevention. Visit his website at haroldoster.com.

References:

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  3. Rahimi IA, Eberhard I, Kasten E. TATTOOS: What Do People Really Know About the Medical Risks of Body Ink? The Journal of clinical and aesthetic dermatology. Mar 2018;11(3):30-35.
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