This may make you think before you ink. A study of people in Sweden found that those who had gotten tattoos were 21% more likely to have subsequently been diagnosed with malignant lymphoma. And this was a case where size didn’t matter—the size of the tattoo, that is. The risk didn’t seem to go up or down based on how large or small the tattoo was in the study recently published in the journal eClinicalMedicine.
Lymphoma is a type of cancer where cells in your lymphatic system change and begin to grow in an uncontrolled manner. Your lymphatic system is part of your immune system that guards against germs and disease like a combination Roomba-sewer-security system. This system includes a number of body parts that you may not think about every day: your spleen, your thymus, your tonsils, your bone marrow and a connected network of lymphatic channels and lymph nodes located in different parts of your abdomen, groin, pelvis, chest, underarms and neck. Various forms of lymphoma can occur in any part of this system and fall under two main subcategories: Hodgkin lymphoma and Non-Hodgkin lymphoma.
For the study, conducted in 2021, three researchers from Lund University in Lund, Sweden (Christel Nielsen, Mats Jerkeman and Anna Saxne Jöud) first used the Swedish National Cancer Register to find everyone 20 to 60 years of age who was diagnosed with malignant lymphoma sometime in the 2007 through 2017 time period. Then, for each of these lymphoma cases, the researchers used the Total Population Register to find three randomly selected controls that had matching ages and sexes. This yielded an initial study population totaling 11,905 people.
Next, the researchers sent each of these people a questionnaire that asked a range of tattoo-relevant questions such as whether the person had any tattoos, when did they get them and how big they were—meaning the tattoos. Ultimately, 54% of the cases or 1398 of them responded and 47% of the the controls or 4193 responded to the questionnaire.
It turned out that a higher percentage of the cases (21% versus 18%) had gotten tattoos than the controls. And those tattooed were 21% more likely to have developed lymphoma. The greatest increases in risk were for diffuse large B-cell lymphoma (a 30% higher likelihood) and follicular lymphoma (a 29% higher likelihood).
The risk of developing lymphoma was highest within the first two years after the person had gotten a tattoo (81% higher than those who hadn’t gotten a tattoo), decreased during the intervening three to ten years and then rose again after the 11-year-mark (19% higher than those who hadn’t gotten a tattoo).
Now, keep in mind that this type of study cannot prove cause-and-effect. It can only show associations. Although getting a tattoo was associated with a higher risk of getting lymphoma regardless of the size of the tattoo, one has to wonder what else might have been different about those who happen to get tattoos. Did they somehow have different diets, different exposures, different amounts of stress or different something-or-other?
Plus, one study is not enough to affirm even just an association. More epidemiology studies are needed to see if tattooing is indeed linked to lymphoma and other health problems. And more other types of studies such as laboratory and clinical studies could help show whether a cause-and-effect situation is actually present.
Nevertheless, it is plausible that the tattooing process could lead to lymphoma. After all, you may not be fully aware of the gunk that’s being injected into you when you get that picture of a hedgehog bowling permanently imprinted on your arm. Tattoo ink can consist of various cancer-causing and potentially cancer-causing agents such as primary aromatic amines, polycyclic aromatic hydrocarbons and different metals like arsenic, chromium, cobalt, lead, and nickel. Yep, when you are getting that tattoo of Justin Bieber’s face planted on your buttock, you may getting more than Bieber fever.
Moreover, tattoo ink being injected into you, can elicit a response from your immune system that, in turn, brings the ink from where it was injected to its final resting place. This means that your lymphatic system is getting involved. In fact, studies have found that tattoo ink can be found in your lymph nodes long after you’ve gotten a tattoo.
Now, it’s not clear what percentage of people who get tattoos may go on to develop lymphoma. Lymphoma is not a super common cancer. The American Cancer Society estimates the chances of a man developing non-Hodgkin’s lymphoma during his lifetime as to be around one in 42 whereas the chances for a woman is a bit lower: around one in 52. Meanwhile, tattooing is a lot more common with 32% of Americans have gotten some kind of ink and 22% having gotten more than one, according to the Pew Research Center. You could say, Pew, tatts quite common but lymphoma not so much.
With tattooing becoming more and more common, there is a need to evaluate what risks may currently be involved in this practice. A number of tattoo parlors that are out there right now don’t exactly scream quality control and evidence-based practice. So it would be helpful to ask important questions such as what about the tattooing process can increase versus decrease risk and are there alternative types of ink that may not have carcinogens? In the meantime, keep in mind the potential longer term effects of anything that you do to your body—besides the possibility that an “Adam loves Brittany” tattoo may not necessarily apply in a few years. What happens in Vegas and just under your skin, may not necessarily stay in that one place under your skin.
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