Haematologists explain why men are more likely to develop lymphoma cancer than women; share hidden factors behind it

Haematologists share insights on why men are disproportionately affected by lymphoma, including hormones, immune system differences, and chemical exposures.

While lymphoma can strike anyone, men are disproportionately affected compared to women. Differences in genetics, hormones, immunity, and lifestyle may play a role. To understand why men face a higher risk, HT Lifestyle has reached out to doctors to break down the factors behind this troubling trend.

The increased incidence of lymphoma in men results from biological, genetic, and environmental factors.

Why lymphoma is more common in men

"Non-Hodgkin Lymphoma is a type of blood cancer that starts in the lymphatic system, which is part of the body's immune system. It occurs when lymphocytes (a type of white blood cell) grow abnormally and form tumours in the lymph nodes or other organs. In India, the most prevalent type of NHL shows a pronounced male predominance in terms of its incidence," says Dr Ashray Kole, clinical haematologist from M|O|C Cancer Care in Thane, Mumbai.

He adds, "According to a study published in the Journal of Cancer Research and Therapeutics, the age-adjusted incidence rates of malignant lymphoma are approximately 2.9 per 100,000 in men compared to 1.5 per 100,000 in women. Regional data further show that in Eastern India, the male-to-female ratio for lymphoma cases is about 3.1:1."

"Lymphoma, a cancer of the lymphatic system, can affect anyone, but men consistently face a higher risk than women. Studies show that non-Hodgkin lymphoma is about one and a half times more common in men. In the U.S., the lifetime risk of developing this cancer is roughly one in 42 for men, compared to one in 54 for women. Even for Hodgkin lymphoma, men remain more vulnerable, with slightly worse outcomes and more aggressive disease patterns," says Dr Vijay Ramanan, Sr. Consultant Clinical Haematologist, Bone Marrow and Stem Cell Transplant, Ruby Hall Clinic, Pune.

Men are at a higher risk for lymphoma due to biological factors, immune system differences, and environmental exposures.

What are the various factors behind male predominance

Dr. Ashray highlights several reasons for the higher prevalence in men:

1. Biological and hormonal factors: Female sex hormones like estrogen and progesterone offer a degree of protection. Higher lifetime estrogen exposure through pregnancy, hormonal contraception, or menstrual cycles has been linked to lower lymphoma risk.

2. Immune system differences: Men and women differ in immune surveillance. Women's stronger immune responses may better eliminate or suppress emerging cancerous lymphocytes, reducing lymphoma risk.

3. Environmental and occupational exposures: Men more often occupy jobs with exposure to carcinogens (chemicals, solvents, agrochemicals) associated with lymphoma development.

4. Tumour biology and body size: Some lymphoma subtypes inherently show greater susceptibility in men. Additionally, taller average body height in men may contribute to elevated cancer risk due to increased stem cell divisions or growth factor exposure.

Dr. Vijay cites the following factors as key reasons:

• Biological and hormonal influences

The immune system is shaped by sex hormones, which may explain part of this difference. Estrogen, the primary female hormone, has protective, anti-cancer effects on immune cells. It reduces the chances of immune system cells turning malignant. Testosterone, on the other hand, may activate pathways that encourage abnormal lymphocyte growth.

Genetics also give women an advantage: many immune-related genes lie on the X chromosome. Since women have two X chromosomes, they may benefit from stronger immune defences than men, who carry only one.

• Environmental risk factors

Beyond biology, environmental exposures play a key role. Men are more likely to work in farming, landscaping, and pesticide-related industries, leading to greater contact with insecticides and herbicides. Long-term exposure to chemicals such as glyphosate, a widely used weed killer, and 2,4-D, a common farming herbicide, has been linked to higher rates of lymphoma. Glyphosate has been tied to increased risk of non-Hodgkin lymphoma, while 2,4-D is associated with DNA damage and higher cancer incidence.

"The greater risk of lymphoma in men arises from both internal biology and external exposures. Protective farming practices, stricter regulation of harmful chemicals, and better awareness can help reduce this risk. Understanding these differences is also crucial for guiding future prevention and treatment strategies," Dr Vijay concludes.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.