Does getting a tattoo increase the risk of developing lymphoma?

Tattoos and Lymphoma Risk

Based on the most recent evidence, tattoos are associated with an increased risk of developing malignant lymphoma, particularly in individuals with larger tattoos and longer exposure durations.

Evidence on Tattoo-Related Cancer Risk

The relationship between tattoos and lymphoma has been increasingly documented in recent research:

• A 2024 population-based case-control study found that tattooed individuals had a 21% higher adjusted risk of overall lymphoma (IRR = 1.21) compared to non-tattooed individuals 1. The risk was particularly elevated:

  • Within the first two years after getting a tattoo (IRR = 1.81)
  • In those who had their first tattoo ≥11 years before diagnosis (IRR = 1.19)
  • For specific subtypes including diffuse large B-cell lymphoma (IRR = 1.30) and follicular lymphoma (IRR = 1.29)

• A 2025 Danish twin study demonstrated an increased hazard of lymphoma among tattooed individuals, with hazard ratios of 2.73 for tattoos larger than the palm of a hand 2.

• Another 2024 study found suggestive evidence of increased risk for certain hematologic cancer subtypes, particularly for rarer mature B-cell non-Hodgkin lymphomas (OR 2.06) with elevated risks for those who received tattoos 10+ years prior (OR 2.64) 3.

Mechanism of Risk

The potential mechanisms explaining this association include:

• Tattoo ink contains potentially carcinogenic chemicals including primary aromatic amines, polycyclic aromatic hydrocarbons, and metals 1, 4.

• About 60-90% of injected pigment is transported to lymph nodes via the lymphatic system and to other organs through blood circulation 4.

• The American Academy of Pediatrics acknowledges that metals in tattoo pigments are emerging as a class of human carcinogens, though concentrations in tattoo ink are typically low 5.

• Chronic inflammation at tattoo sites and regional lymph nodes may increase the risk of abnormal cell proliferation 2.

Risk Factors and Considerations

The risk appears to be influenced by:

1. Size of tattoo: Larger tattoos (greater than palm-sized) show higher hazard ratios for lymphoma 2.

2. Duration of exposure: Both recent tattoos (<2 years) and long-term exposure (≥11 years) show elevated risk profiles 1.

3. Tattoo placement and number: While specific placement data is limited, the total area of tattooed skin may contribute to risk.

Clinical Implications

For healthcare providers:

• Lesions that appear to grow or change within a tattoo warrant evaluation for neoplasms 5.

• Patients with tattoos should be informed about potential long-term risks, particularly those with extensive tattoo coverage.

• Consider tattoo history when evaluating patients with unexplained lymphadenopathy, especially if regional to tattoo sites.

Limitations and Caveats

• While recent epidemiological studies show associations, causality has not been definitively established.

• The American Academy of Pediatrics notes that with the large number of tattoos placed daily and few reports of complications, the overall rate of serious adverse events is likely low 6.

• Other risk factors for lymphoma include tobacco use, obesity, genetic predisposition, and certain infections 7, which may confound the relationship.

The evidence suggests that while the absolute risk remains relatively low, patients considering tattoos should be informed about the potential increased risk of lymphoma, particularly with extensive tattooing. Those with existing tattoos should be vigilant about changes within or around tattoo sites.