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Definite risk factors for non Hodgkin lymphoma

Men and women discussing non Hodgkin's lymphoma

This page is about the definite risk factors for non Hodgkin lymphoma. You can find the following information

 

A quick guide to what's on this page

Definite risk factors for non Hodgkin lymphoma

There are some risk factors that we know about for NHL. But most people who get non Hodgkin lymphoma do not have any of them. Doctors just don't know why most people get this disease.

Age and gender

Although non Hodgkin lymphoma can happen at any age, around 6 in 10 of all cases (60%) are diagnosed in people aged 65 and over. Overall, NHL is slightly more common in men than in women.

Having a weakened immune system

Anyone whose immune system is not working as well as it should may be more likely to develop a lymphoma. This includes people taking drugs to stop organ rejection after a transplant, people who have HIV or AIDS, and those with autoimmune diseases.

Other risks

Infection with some viruses and bacteria can increase the risk of developing NHL. However, many of these infections are uncommon in the UK. So the actual number of cases caused by infections is small.

People with coeliac disease have an increased risk of some types of NHL. But most people with coeliac disease will never get lymphoma.

If you have a parent, brother or sister diagnosed with NHL, you have about 2 to 3 times the average risk of developing it yourself. But remember that the general risk of NHL is low, so this increase in risk is still small. If you've had a melanoma or some other types of cancer, you have an increased risk of NHL. It's not completely clear why this is.
 

CR PDF Icon You can view and print the quick guides for all the pages in the about NHL section.

 

 

How common NHL is

Almost 12,800 cases of non Hodgkin lymphoma are diagnosed each year in the UK. This makes it the 6th most common type of cancer in adults (not counting non melanoma skin cancer). Out of every 100 cancers diagnosed, around 4 are NHL (4%).

 

Having no known risk factors

Doctors don't know the cause in most people who get non Hodgkin lymphoma. Research is going on all the time to try to find out what causes it. There are some possible risk factors on the next page in this section.

Like all cancers, non Hodgkin lymphoma is not infectious. You can't catch it from someone who has it.

 

Age and gender

Although non Hodgkin lymphoma can happen at any age, around 6 in 10 of all cases (60%) are diagnosed in people aged 65 and over. Overall, NHL is slightly more common in men than in women.

 

Weakened immune system

People whose immune system is not working as well as it should are more likely to develop a lymphoma. Immunity can be lowered for the following reasons

  • Taking drugs to stop organ rejection after a transplant
  • HIV or AIDS
  • Being born with rare medical conditions which affects immunity
  • Autoimmune diseases

Auto immune disease includes rheumatoid arthritis, haemolytic anaemia, coeliac disease, Sjogren's syndrome and systemic lupus erythematosus.

 

Infections

A number of viruses and bacteria have been linked with an increase risk of NHL. However, many of these infections are uncommon in the UK. So the actual number of NHL cases caused by infections is small. The infection is only part of a complex process for cancer to develop. Most people with these infections won't go on to develop NHL. And it does not mean that NHL itself is infectious.

Infection with a virus called human T cell lymphoma virus 1 (HTLV1) can increase the risk of developing NHL. This is most common in Japan and the Caribbean. Another virus called Epstein Barr virus is linked to an increased incidence of a type of NHL that is more common in Africa than Europe. It is called Burkitt's lymphoma. 

A more common bacterial infection, called Helicobacter pylori, can cause a rare type of lymphoma that starts in the stomach. This type of lymphoma is called MALT lymphoma. MALT stands for mucosa associated lymphoid tissue. This means that the lymphoma starts in lymphatic tissue outside the main lymphatic system. In this case, in the lining of the stomach.

People with the hepatitis C virus have 2 or 3 times the normal risk of NHL. The hepatitis B virus also appears to increase the risk of NHL.

 

Coeliac disease

Coeliac disease is a disease of the small bowel. It affects about 1 in every 250 people. People with coeliac disease have an immune reaction to gluten, a protein found in rye, wheat and barley. This reaction causes inflammation of the small bowel. 

For some time, coeliac disease has been a known risk factor for a rare type of lymphoma of the small bowel, called enteropathy type T cell lymphoma (ETTL). More recently, research has shown an increased risk of B cell non Hodgkin lymphomas too. The risk seems to be higher in people with poorly managed coeliac disease. This is supported by research showing that the risk of NHL in people with a diagnosis of coeliac disease has reduced over recent decades. Sticking to a gluten free diet may help reduce your risk if you have coeliac disease. 

There is more information about the risk of NHL in people with coeliac disease in the questions and answers section. A recent study also suggests that people who have a brother or sister with coeliac disease may also have an increased risk of NHL.

 

Family history of NHL

If you have a parent, brother or sister diagnosed with NHL, you have a slightly increased risk of getting it yourself. It's about 2 to 3 times the average risk. If this seems high, do remember that the general risk of NHL is small. And most people who get NHL don't have a relative who has had it, so it isn't a major risk factor.

 

Previous cancer and treatment

Some types of cancer, particularly blood cancers such as Hodgkin lymphoma and leukaemia, have been linked to an increased risk of NHL. Working out if this increase in risk is due to shared risk factors or because of the treatment itself is not straightforward.

However, there have been some studies that show some chemotherapy drugs and radiotherapy may increase your risk of developing NHL. People who have had radiotherapy for breast cancer or Hodgkin lymphoma have an increased risk of NHL in the area that was treated. But these are very small increases in risk, compared to the risk of not having the treatment for the original cancer.

If you've had a melanoma, you have double the usual risk of NHL. People who have had NHL also have an increased risk of melanoma. There is some evidence that after a non melanoma skin cancer your risk of NHL is 2 or 3 times higher than in the general population. It is not clear yet why this is.

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Updated: 14 January 2014