Risk Factors for Follicular Lymphoma (FL)

The etiology of FL is poorly understood; however, it has been suggested that age and ethnicity may affect the likelihood a person will develop FL.1,2

Age

The incidence of FL increases with age, with a median age of diagnosis of 60-65 years, and FL is extremely rare in children.1

Race/Ethnicity

In the US, the incidence of FL is higher in Caucasians than African Americans.2

Additional Risk Factors that May Increase the Risk of Developing NHL3,4:

  • Immunologic factors, including immunodeficiency, infection with human immunodeficiency virus (HIV), and genetic disorders that cause weakened immune function (primary immunodeficiency)
  • Autoimmune disorders lead to overactivity of the immune system, which can make lymphocytes grow and divide more than normal, increasing the opportunity for lymphoma-causing mutations to arise
  • Some infections, in particular, viruses that can directly alter the DNA of lymphocytes, such as Epstein-Barr virus (EBV), human T‍-‍lymphotropic virus 1 (HTLV-1), and human herpes virus 8 (HHV-8)
  • Patients have an increased risk of NHL if they have a first degree relative (parent, child, sibling) with a history of NHL
  • Prior cancer therapy, including chemotherapy or radiation therapy
  • Chemical or environmental exposure
  • Lifestyle factors, including smoking, diet, and obesity

References: 1. Ma S. Risk factors for follicular lymphoma. Expert Opin Med Diagn. 2012; 6(4): 323–333. 2. National Cancer Institute. SEER Cancer Statistics Facts: NHL – Follicular Lymphoma. https://seer.cancer.gov/statfacts/html/follicular.html. Accessed June 12, 2019. 3. Merck Manual. 20th ed. Lane KAG, ed. Rahway, New Jersey: Merck & Co., Inc. 2018. 4. American Cancer Society. Non-Hodgkin Lymphoma Risk Factors. https://www.cancer.org/cancer/non-hodgkin-lymphoma/causes-risks-prevention/risk-factors.html. Accessed June 14, 2019.