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Why Are Men More Likely To Develop Most Lymphomas?

Posted on January 27, 2022
Medically reviewed by
Todd Gersten, M.D.
Article written by
Nyaka Mwanza

More often than not, the average risk of lymphoma is higher if your biological sex is male than if it is female. There are two primary types of lymphoma — Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Men are at a greater risk for both.

Although the difference is slight, most new lymphoma cases are diagnosed in men. In 2022, the American Cancer Society estimates that about 80,000 people in America will be diagnosed with NHL, and more than 45,000 will be men. Of the almost 9,000 people who will be diagnosed with HL this year, nearly 5,000 will be men.

Why Is There a Sex Difference?

Doctors and researchers are not certain why men are at increased risk of developing most types of lymphoma. They don’t yet fully understand how and why a person’s sex influences their risk of developing this type of cancer. Research is ongoing, although there are strong theories.

More study is needed, but some research suggests that the unique hormonal changes that a woman experiences when pregnant (and if they undergo hormone therapy for menopause) have something to do with decreased risk. Reproductive factors, meaning the biological differences that allow people to procreate, may play some role in why men are diagnosed with lymphoma more often than women.

Specifically, researchers suspect that the female sex hormones associated with a woman’s reproductive cycle (estrogen and progesterone) provide some level of protection from lymphoma, slow the rate of lymphoid cancer cells’ growth, and decrease the likelihood of metastasis. The use of hormonal birth control pills also appears to reduce a woman’s lymphoma risk. The risk of certain lymphomas is especially reduced among people who have been pregnant and even more so among those who have been pregnant more than once. Some studies suggest that women who have had a hysterectomy face a higher risk of a type of lymphoma called follicular lymphoma.

These findings suggest that the higher a person’s levels of estrogen are, the more protection they may have from lymphoma. Men don’t have the same levels of potentially protective female hormones, so they may be more at risk.

Other Risk Factors for Lymphoma

A risk factor is something — such as a gene or toxic chemical — that may make a person more likely to develop a disease such as lymphoma. Having one risk factor, such as being male, does not mean a person will develop lymphoma. It just means that that person may be slightly more likely to develop lymphoma than another person who has no lymphoma risk factors.

The development of lymphoma often depends on a combination of genetic and environmental risk factors. In addition to biological sex, other risk factors for lymphoma include:

  • Older age, although some lymphomas are more likely in young adults
  • Family history of lymphoma, especially in a parent or sibling
  • Certain infections, including Epstein-Barr virus and HIV infection
  • Autoimmune diseases
  • Some chemotherapies and radiation therapy
  • Exposure to certain chemicals
  • Obesity

On the other hand, some people who have lymphoma don’t have any lymphoma risk factors. Similarly, many people with one or more risk factors for lymphoma will never develop this type of cancer.

Are All Lymphomas More Common in Men Than in Women?

Although lymphomas are generally more commonly diagnosed in men, certain lymphoma subtypes are found more often in women. Lymphoma is the sixth most common type of cancer in women.

Follicular Lymphoma

Follicular lymphoma is the second-most common type of NHL comprising between 30 percent and 35 percent of NHL diagnoses. Follicular lymphoma is one of the few lymphomas more commonly seen in women than in men. Follicular lymphoma can sometimes turn into a type of lymphoma known as diffuse large B-cell lymphoma (DLBCL), another subtype more common in women than in men.

Primary Mediastinal Large B-Cell Lymphoma

DLBCL is most commonly found in women between 30 and 40 years of age. Primary mediastinal large B-cell lymphoma is a subtype of DLBCL that accounts for approximately 2.5 percent of NHL cases. Mediastinal gray-zone lymphoma, a similar subtype of lymphoma, is also more likely to affect women in the same age range than it affects men.

Breast Implant-Associated Anaplastic Large Cell Lymphoma

Breast implant-associated anaplastic large cell lymphoma, a subtype of anaplastic large cell lymphomas, is more common in women than in men. This lymphoma subtype begins in tissue near and around breast implants.

Primary Breast Lymphoma

Primary breast lymphoma is a rare NHL subtype that is almost exclusively diagnosed in women. Fewer than 1 percent of people diagnosed with NHL are diagnosed with primary breast lymphoma.

Nodular Sclerosis Hodgkin Lymphoma

Nodular sclerosis HL is a type of lymphoma most commonly diagnosed in young, adult women and is the most common subtype of classic HL. Accounting for between 80 percent and 95 percent of HL diagnoses, class HL is the most commonly diagnosed type of Hodgkin disease.

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References
  1. Types of Lymphoma — Lymphoma Action
  2. Causes and Risk Factors for Lymphoma — Lymphoma Action
  3. Non-Hodgkin and Non-Hodgkin Lymphoma Risk Factors — Rogel Cancer Center University of Michigan Health
  4. Lymphoma — Mayo Clinic
  5. Lymphoma — Centers for Disease Control and Prevention
  6. Cancer Stat Facts: Non-Hodgkin Lymphoma — National Cancer Institute
  7. Lymphoma — Patient Version — National Cancer Institute
  8. United States Cancer Statistics: Data Visualizations — Centers for Disease Control and Prevention
  9. Non-Hodgkin Lymphoma Risk Factors — American Cancer Society
  10. What Causes Non-Hodgkin Lymphoma? — American Cancer Society
  11. Hodgkin Lymphoma Risk Factors — American Cancer Society
  12. What Causes Hodgkin Lymphoma? — American Cancer Society
  13. Does Gender Matter in Non-Hodgkin Lymphoma? Differences in Epidemiology, Clinical Behavior, and Therapy — Rambam Maimonides Medical Journal
  14. Lymphoma — Non-Hodgkin: Subtypes — Cancer.Net
  15. Lymphoma — Hodgkin: Introduction — Cancer.Net
  16. Lymphoma — Non-Hodgkin: Introduction — Cancer.Net
  17. Lymphoma — Non-Hodgkin: Statistics — Cancer.Net
  18. Lymphoma — Hodgkin: Risk Factors — Cancer.Net
  19. Lymphoma — Non-Hodgkin: Risk Factors — Cancer.Net
  20. How Are HIV and AIDS Related to Cancer? — American Cancer Society
  21. Non-Hodgkin Lymphoma in Women: Reproductive Factors and Exogenous Hormone Use — American Journal of Epidemiology
  22. Gender in Endocrine Diseases: Role of Sex Gonadal Hormones — International Journal of Endocrinology
  23. Key Statistics for Non-Hodgkin Lymphoma — American Cancer Society
All updates must be accompanied by text or a picture.
Todd Gersten, M.D. is a hematologist-oncologist at the Florida Cancer Specialists & Research Institute in Wellington, Florida. Review provided by VeriMed Healthcare Network. Learn more about him here.
Nyaka Mwanza has worked with large global health nonprofits focused on improving health outcomes for women and children. Learn more about her here.

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