Risk factors for Hodgkin lymphoma

A risk factor is something that increases the risk of developing cancer. It could be a behaviour, substance or condition. Most cancers are the result of many risk factors. But sometimes Hodgkin lymphoma (HL) develops in people who don’t have any of the risk factors described below.

HL affects men slightly more often than women. It most commonly develops in younger adults (people in their mid-teens through their 30s) and in people 55 years of age and older.

Risk factors are generally listed in order from most to least important. But in most cases, it is impossible to rank them with absolute certainty.

Risk factors

Epstein-Barr virus infection

Family history

HIV infection

There is convincing evidence that the following factors increase your risk for HL.

Epstein-Barr virus infection

Long-term infection with the Epstein-Barr virus (EBV) is a risk factor for HL. EBV is a type of herpes virus that causes infectious mononucleosis (also called mono, or the kissing disease). Many people are infected with EBV, but only some of them develop a long-term infection.

Find out more about Epstein-Barr virus (EBV).

Family history

First-degree relatives of a person with HL, particularly siblings of the same sex, have a higher risk of developing the disease. It is unclear if the higher risk is due to genetics alone or a combination of genetics and being exposed to similar factors in the environment.

HIV infection

The human immunodeficiency virus (HIV) is the virus that causes AIDS. HIV weakens the body’s immune system and may leave people vulnerable to certain types of cancer, including HL. The risk of developing HL is 10 times higher in people with HIV than in people without the virus.

Find out more about human immunodeficiency virus (HIV).

Possible risk factors

The following factors have been linked with HL, but there is not enough evidence to show for sure that they are risk factors. More research is needed to clarify the role of these factors for Hodgkin lymphoma.

  • certain genetic factors
  • infectious mononucleosis
  • autoimmune diseases, including rheumatoid arthritis, systemic lupus erythematosus, ulcerative colitis, sarcoidosis and immune thrombocytopenic purpura
  • immune deficiency (when the immune system is not working properly)
  • smoking tobacco
  • socioeconomic status and types of families, such as higher social class, fewer siblings and playmates, less crowded housing or early birth order

Questions to ask your healthcare team

To make the decisions that are right for you, ask your healthcare team questions about risks.

Expert review and references

  • Buck CB, Ratner L, Tosato G . Oncogenic viruses. DeVita VT Jr., Lawrence TS, Rosenberg SA (eds.). DeVita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. 11th ed. Philadelphia: Wolters Kluwer; 2019: 7:98-114.
  • Hjalgrim H, Chang ET, Glaser SL . Hodgkin lymphoma. Thun MJ (ed.). Schottenfeld and Fraumeni Cancer Epidemiology and Prevention. 4th ed. New York, NY: Oxford University Press; 2018: 39: 745 - 765.
  • International Agency for Research on Cancer (IARC). Volume 100C: Arsenic, metals, fibres and dusts: a review of human carcinogens. 2012: http://monographs.iarc.fr/ENG/Monographs/vol100C/mono100C.pdf.
  • International Agency for Research on Cancer (IARC). Volume 100D: Radiation: a review of human carcinogens. 2011: http://monographs.iarc.fr/ENG/Monographs/vol100D/mono100D.pdf.
  • International Agency for Research on Cancer (IARC). Volume 100E: Personal Habits and Indoor Combustions. 2012: http://monographs.iarc.fr/ENG/Monographs/vol100E/mono100E.pdf.
  • Melbye M, Hjalgrim H, Adami H . Hodgkin lymphoma. Adami HO, Hunter D, Trichopoulos D. Textbook of Cancer Epidemiology. 2nd ed. Oxford: Oxford University Press; 2008: 26:653-668.
  • Mueller NE, Grufferman S . Hodgkin lymphoma. Schottenfeld D, Fraumeni JF Jr. (eds.). Cancer Epidemiology and Prevention. 3rd ed. New York: Oxford University Press; 2006: 45:872-897.

Reducing your risk for Hodgkin lymphoma

Family history is a risk factor for Hodgkin lymphoma (HL) that cannot be changed. Learn about factors that may reduce HL risk.