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Hodgkin Lymphoma Risk Factors

A risk factor is anything that affects your chance of getting a disease such as cancer. Different cancers have different risk factors. Some cancer risk factors, like smoking or being overweight, can be changed. Others, like a person’s age or family history, can’t be changed.

A few risk factors make a person more likely to develop Hodgkin lymphoma (HL), but it’s not always clear why these factors increase risk. Having a risk factor, or even many, does not mean that you'll definitely get the disease. And many people who get HL have few or no known risk factors.

Epstein-Barr virus infection/mononucleosis

The Epstein-Barr virus (EBV) causes infectious mononucleosis (often called mono). People who have had mono have an increased risk of HL. But even though the risk is higher than for people who haven't had mono, it is still very small (about 1 in 1,000).

The exact role of EBV in the development of HL isn't clear. Many people are infected with EBV, but very few develop HL. Parts of the virus are found in Reed-Sternberg cells in about 1 out of 4 people with classic HL in the US. But most people with HL have no signs of EBV in their cancer cells. 


People can be diagnosed with HL at any age, but it's most common in early adulthood (especially in a person’s 20s) and in late adulthood (after age 55).


HL occurs slightly more often in males than in females.

Family history

Brothers and sisters of young people with this disease have a higher risk for HL. The risk is very high for an identical twin of a person with HL. But a family link is still uncommon – most people with HL do not have a family history of it.

It’s not clear why family history might increase risk. It might be because family members have similar childhood exposures to certain infections (such as Epstein-Barr virus), because they share inherited gene changes that make them more likely to get HL, or some combination of these factors.  

Weakened immune system

The risk of HL is increased in people infected with HIV, the virus that causes AIDS.

People who take medicines to suppress the immune system after an organ transplant and people with auto-immune diseases are also at higher than normal risk for HL.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as editors and translators with extensive experience in medical writing.

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National Cancer Institute. Adult Hodgkin Lymphoma Treatment (PDQ®)–Patient Version. April 20, 2017. Accessed at on March 15, 2018.

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Last Revised: May 1, 2018

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