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


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


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.