Tattoos may be a risk factor for lymphoma

Tattoos may be a risk factor for malignant lymphoma, according to a Swedish population-based case-control study.

Of nearly 12,000 people included in the study, those with tattoos had a higher risk of overall lymphoma compared to people without tattoos (incidence ratio (IRR) 1.21, 95% CI 0.99-1.48) after adjusting for factors such as education, age, income, and smoking, Christel Nielsen, PhD, of Lund University in Sweden, and colleagues reported.

This association was strongest for those with diffuse large B-cell lymphoma (IRR 1.30, 95% CI 0.99-1.71), followed by follicular lymphoma (IRR 1.29, 95% CI 0.92-1 .82), they observed in eMedicineClinical.

Of note, the risk of lymphoma was highest in those with less than 2 years between their first tattoo and the index year (IRR 1.81, 95% CI 1.03-3.20) and decreased with intermediate exposure duration. (3 to 10 years), but increased again in those who received their first tattoo ≥11 years before the index year (IRR 1.19, 95% CI 0.94-1.50).

“Further epidemiological research is urgently needed to establish causality,” Nielsen and colleagues wrote. “The study underscores the importance of regulatory measures to control the chemical composition of tattoo ink.”

“If these findings can be corroborated by additional studies, they would indicate that exposure to tattoo ink may be associated with both tumor initiation, which is often associated with a latency of several years, and tumor promotion, where the effects occur much faster,” they added. .

In a press release, Nielsen noted that “people will likely want to continue to express their identity through tattoos and therefore it is very important that we, as a society, can ensure that it is safe. For the individual, it is good know it.” that tattoos can affect his health and that he should consult his healthcare provider if he experiences symptoms that he believes could be related to his tattoo.”

The authors noted that the popularity of tattoos has increased dramatically in recent decades, with prevalence rates exceeding 20% ​​in several European countries and around 30% in the US.

Since people typically start getting tattoos at younger ages, this means they could be exposed to the ingredients in tattoo ink, which often contain carcinogenic chemicals, “for almost a lifetime,” Nielsen and his team wrote. . “However, research has only begun to scratch the surface of understanding the long-term health effects of tattoos.”

For this study, the researchers identified all incident cases of malignant lymphoma diagnosed between 2007 and 2017 in patients aged 20 to 60 years in the Swedish National Cancer Registry. Three random controls matched by age and sex per patient were sampled from the Total Population Registry using incidence density sampling.

The study included 11,905 people (2,938 with lymphoma and 8,967 controls). Among those with lymphoma, 54 percent answered a questionnaire about tattoo exposure compared with 47 percent in the control group, and 21 percent versus 18 percent, respectively, were tattooed.

The most common subtypes of lymphoma were diffuse large B-cell lymphoma (28%), Hodgkin lymphoma (21%), and follicular lymphoma (18%). The mean age at diagnosis ranged from 51 to 57 years, except among patients with Hodgkin lymphoma (mean age 36 years). Men made up more than half of each group.

Respondents provided their age at first tattoo, as well as tattoo characteristics such as color, body surface area tattooed (<1, 1-5 o >5 palms), the skill level of the tattoo artist (professional or amateur) and the body part tattooed.

The authors noted that while it “seems intuitive” that greater tattooed body surface area would be associated with increased lymphoma risk, they found no evidence of an exposure-response relationship.

Instead, they found that the highest risk of lymphoma occurred in people with tattoos smaller than the palm of a hand (IRR 1.27, 95% CI 0.99-1.63).

Nielsen and his colleagues recognized that, as in any case-control study, “elective participation is a generic concern that can distort the results. The fact that we could not formally evaluate possible selection bias because we did not have access to data to individual level on non-participants is a limitation.”

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    Mike Bassett is an oncology and hematology writer. He is based in Massachusetts.

Disclosures

The study was funded by the Swedish Research Council for Health, Working Life and Welfare.

The authors had no disclosures.

Main source

eMedicineClinical

Reference source: Nielsen C, et al “Tattoos as a risk factor for malignant lymphoma: a population-based case-control study” eClinicalMedicine 2024; DOI: 10.1016/j.eclinm.2024.102649.