Hodgkin’s lymphoma (HL) is a cancer originating in the lymphatic system, part of the body’s immune network. The disease involves the uncontrolled growth of specific white blood cells called B lymphocytes, often characterized by Reed-Sternberg cells. Since the exact cause for most cases remains largely unknown, primary prevention is difficult. However, reducing exposure to established risk factors can proactively lower one’s overall risk.
Identifying Established Risk Factors
Understanding established risk factors is important, even though many cannot be altered. Age is a non-modifiable risk, showing a distinct bimodal pattern that affects young adults (20 to 40) and adults over 55. Males have a slightly higher risk of diagnosis compared to females.
A family history, especially having a close relative with HL, suggests a possible genetic component or shared environmental exposure. Race and ethnicity are also noted risk factors, though the reasons are complex and not fully understood. These demographic factors increase awareness but do not offer direct avenues for prevention.
Managing Immune System Health
Maintaining robust immune function is an actionable area for risk reduction, as a weakened immune system is a known risk factor. Immunodeficiency impairs the body’s ability to control abnormal cell growth. People living with Human Immunodeficiency Virus (HIV) face a significantly higher risk of HL, estimated to be 5 to 15 times greater than the general population.
Consistent Antiretroviral Therapy (ART) is a direct form of risk reduction. Maintaining a high CD4 T-cell count helps restore immune surveillance, protecting against cancer development. Individuals taking long-term immunosuppressive drugs, such as after an organ transplant, also have an elevated risk.
Close medical monitoring and careful adjustment of these medications are necessary to balance immune suppression with cancer risk mitigation. General lifestyle choices also support a healthy immune system and reduce overall cancer risk. These include avoiding tobacco smoking, maintaining a healthy body weight, regular exercise, a nutritious diet, and sufficient sleep.
The Connection to Epstein-Barr Virus
The Epstein-Barr Virus (EBV) is a prominent biological risk factor, found in the tumor cells of 25 to 40% of HL cases in the United States. EBV is a common herpesvirus transmitted through bodily fluids, especially saliva, and causes infectious mononucleosis (mono). Although most people infected with EBV never develop cancer, having had mono is associated with an increased, though small, risk of later developing HL.
The virus alters the immune system and attaches to B-cells, supporting the survival and growth of malignant cells. EBV-linked HL may have an incubation period of about four years after an EBV-related illness. Currently, there is no widely available, licensed vaccine that prevents EBV infection.
Experimental vaccines have shown promise in reducing infectious mononucleosis incidence but have not prevented the initial viral infection. Research is ongoing, as a vaccine preventing primary EBV infection would significantly impact associated cancers. Since EBV is widespread, avoiding initial infection is challenging. Simple hygiene practices, such as avoiding the sharing of drinks or eating utensils with symptomatic individuals, are the only current non-medical measures to limit transmission.