Do tattoos cause lymphoma?

Not so long ago, a friend texted me from a coffee shop. He said, "I can't believe it. I'm the only one here without a tattoo!" That might not seem surprising: a quick glance around practically anywhere people gather shows that tattoos are widely popular.

Nearly one-third of adults in the US have a tattoo, according to a Pew Research Center survey, including more than half of women ages 18 to 49. These numbers have increased dramatically over the last 20 years: around 21% of US adults in 2012 and 16% of adults in 2003 reported having at least one tattoo.

If you're among them, some recent headlines may have you worried:

              Study Finds That Tattoos Can Increase Your Risk of Lymphoma (OnlyMyHealth)

              Getting a Tattoo Puts You At Higher Risk of Cancer, Claims Study (NDTV)

              Inky waters: Tattoos increase risk of lymphoma by over 20%, study says (Local12.com)

              Shocking study reveals tattoos may increase risk of lymphoma by 20% (Fox News)

What study are they talking about? And how concerned should you be? Let's go through it together. One thing is clear: there's much more to this story than the headlines.

Why are researchers studying a possible link between tattoos and lymphoma?

Lymphoma is a type of cancer that starts in the lymphatic system, a network of vessels and lymph nodes that twines throughout the body. With about 90,000 newly diagnosed cases a year, lymphoma is one of the most common types of cancer.

Risk factors for it include:

• advancing age
• certain infections (such as Epstein-Barr virus, HIV, and hepatitis C)
• exposure to certain chemicals (such as benzene, or possibly pesticides)
• family history of lymphoma
• exposure to radiation (such as nuclear reactor accidents or after radiation therapy)
• having an impaired immune system
• certain immune diseases (such as rheumatoid arthritis, Sjogren's disease, or celiac disease).

Tattoos are not known to be a cause or risk factor for lymphoma. But there are several reasons to wonder if there might be a connection:

• Ink injected under the skin to create a tattoo contains several chemicals classified as carcinogenic (cancer causing).
• Pigment from tattoo ink can be found in enlarged lymph nodes within weeks of getting a tattoo.
• Immune cells in the skin can react to the chemicals in tattoo ink and travel to nearby lymph nodes, triggering a bodywide immune reaction.
• Other triggers of lymphoma, such as pesticides, have a similar effect on immune cells in lymph nodes.

Is there a connection between tattoos and lymphoma?

Any potential connection between tattoos and lymphoma has not been well studied. I could find only two published studies exploring the possibility, and neither found evidence of a compelling link.

The first study compared 737 people with the most common type of lymphoma (called non-Hodgkin's lymphoma) with otherwise similar people who did not have lymphoma. The researchers found no significant difference in the frequency of tattoos between the two groups.

A study published in May 2024 — the one that triggered the scary headlines above — was larger. It compared 1,398 people ages 20 to 60 who had lymphoma with 4,193 people who did not have lymphoma but who were otherwise similar. The study found that

• lymphoma was 21% more common among those with tattoos
• lymphoma risk varied depending on how much time had passed since getting the tattoo:
  • within two years, lymphoma risk was 81% higher
  • between three and 10 years, no definite increased lymphoma risk was detected
  • 11 or more years after getting a tattoo, lymphoma risk was 19%

There was no correlation between the size or number of tattoos and lymphoma risk.

What else should you know about the study?

Importantly, nearly all of the differences in rates of lymphoma between people with and without tattoos were not statistically significant. That means the reported link between lymphoma and tattoos is questionable — and quite possibly observed by chance. In fact, some of the other findings argue against a connection, such as the lack of a link between size or number of tattoos and lymphoma risk.

In addition, if tattoos significantly increase a person's risk of developing lymphoma, we might expect lymphoma rates in the US to be rising along with the popularity of tattoos. Yet that's not the case.

Finally, a study like this one (called an association study) cannot prove that a potential trigger of disease (in this case, tattoos) actually caused the disease (lymphoma). There may be other factors (called confounders) that are more common among people who have tattoos, and those factors might account for the higher lymphoma risk.

Do tattoos come with other health risks?

While complication rates from reputable and appropriately certified tattooists are low, there are health risks associated with tattoos:

• infection, including bacterial skin infections or viral hepatitis
• allergic reactions to the ink
• scarring
• rarely, skin cancer (melanoma and other types of skin cancer).

The bottom line

Despite headlines suggesting a link between tattoos and the risk of lymphoma, there's no convincing evidence it's true. We'll need significantly more research to say much more than that. In the meantime, there are more important health concerns to worry about and much better ways for all of us to reduce cancer risk.