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Lund – A recent case-control study using registry data from Sweden provides initial evidence that people with tattoos are at higher risk of developing malignant lymphomas. Therefore, intensified research activities on the long-term health effects of tattoos would be useful (eClinicalMedicine2024; DOI: 10.1016/j.eclinm.2024.102649).

Tattoos have been popular for decades and emphasize the individuality of each person. However, getting a tattoo triggers an immunological reaction, which can, among other things, contribute to part of the tattoo ink getting from the injection site into the lymph nodes.

In addition, tattoo ink sometimes contains carcinogenic chemicals, such as primary aromatic amines, polycyclic aromatic hydrocarbons and metals. Little is known about the long-term health effects of tattoo pigment deposition in lymph nodes.

Now scientists analyzed Swedish registry data to detect a possible connection between the presence of tattoos and malignant lymphomas as well as other lymphoma subtypes.

As part of this analysis, 11,905 people were included. Of these, 2,938 people developed lymphoma when they were between 20 and 60 years old. In the group with lymphoma, 21% were tattooed, while in the control group without a lymphoma diagnosis, this proportion was 18%.

“After taking into account other relevant factors such as smoking and age, we found that the risk of developing lymphoma was 21% higher among those with tattoos,” reported lead author Christel Nielsen, professor in the Department of Occupational and Environmental Medicine at Lund University (Sweden).

According to their results, tattooed people had a higher adjusted risk of lymphoma with an incidence rate ratio (IRR) of 1.21 (95% confidence interval [95-%-CI] 0.99–1.48), which was highest in the first 2 years after tattooing.

With increasing exposure time (3-11 years), the risks initially decreased before increasing again from the 11th year onwards (IRR 1.19; 95% CI 0.94-1.50). The risk associated with tattooing appeared to be highest for diffuse large B-cell lymphoma (IRR 1.30; 95% CI 0.99-1.71) and follicular lymphoma (IRR 1.29; 95% CI 0.92-1.82). However, the expert pointed out that research on this is not yet complete.

“The results now need to be verified and further investigated in other studies. Especially because lymphomas are a rare disease and our results are based on a single retrospective case-control study,” said Nielsen.

The working group originally assumed that the size of the tattoo, such as a full-body tattoo, could be associated with a higher cancer risk than a small butterfly on the shoulder. However, it turned out that the area of ​​the tattooed body surface did not matter.

“We don’t yet know why that was the case. We can only speculate that a tattoo, regardless of its size, triggers a low-grade inflammation in the body, which in turn can cause cancer. So the picture is more complex than we initially thought,” Nielsen admitted.

It seems plausible to the study authors that immune reactions caused by certain chemicals in the tattoo ink and deposited in the lymphatic system could be related to the development of lymphomas.

It would therefore be important to continue researching the long-term health effects of tattoos. The working group is staying on the topic and will conduct further studies to find out whether there is a connection between tattoos and other types of cancer or inflammatory diseases. © cw/aerzteblatt.de