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Firefighter Cancer

Establishing a comprehensive firefighter cancer strategy is 1 of 7 critical issues identified for action on the part of the federal government during the 2023 Fire Administrator’s Summit.

Establish a comprehensive firefighter cancer strategy that invests in research, provides access to cancer screening for firefighters, and reduces and eliminates PFAS exposure.

Issue: Firefighters have a 9% higher risk of developing cancer and a 14% higher risk of dying from cancer compared to the general public.

Prior the 2022 Summit, the World Health Organization’s International Agency for Research on Cancer (IARC) rated a firefighter’s occupational exposure at its highest level, a “Class 1 threat carcinogenic to humans1.” The IARC Working Group cited other findings, including “sufficient evidence” to connect the occupational exposures associated with firefighting with mesothelioma and bladder cancer. They also found “limited evidence” to link firefighting and colon, prostate, and testicular cancer.

IARC’s designation is a game changing opportunity to further consolidate hard-won gains in research and knowledge into profound impacts.

Impact areas


More investment in research is needed to expand our understanding of the mechanisms between occupational exposures and cancer, including why firefighters are at heightened risk from some cancers. Research is also needed to understand better the cancer risks of under-studied populations, including women and people of color.

In 2018, Congress funded the creation of the National Firefighter Registry (NFR) for Cancer. The registry is open to all firefighters and is the largest effort to date to investigate and reduce cancer risk in U.S. firefighters. The registry is a critical pathway to addressing cancer risk, and all firefighters are encouraged to register2.

Access to cancer screenings

Preventative screenings can identify cancer in its earliest stages when positive treatment outcomes are more likely. Nevertheless, it remains difficult for individual firefighters to receive early screenings as current screening guidance does not account for their occupational exposures. Revised screening guidance can help medical professionals and insurance companies understand the need to screen firefighters based on their higher cancer risk.

Reduce and eliminate PFAS and other toxicant exposures

PFAS and other toxicants disrupt an individual’s fundamental physiology, leading to wide-ranging negative health impacts for firefighters, including cancer and heart disease as well as sleep and reproduction issues.

PFAS are carcinogenic chemicals that degrade very slowly, earning the label “forever chemicals.” PFAS are found in a firefighter’s blood, their firehouses, some firefighting foams, and perhaps most concerning, bunker gear3. Next-generation PFAS-free PPE, along with science and risk-based mitigation programs, can lessen these risks.

Firefighters: Sign up for the National Firefighter Registry

The registry is the largest effort ever undertaken to understand and reduce risk of cancer among U.S. firefighters. The National Institute for Occupational Safety and Health is recruiting firefighters to join the registry so that it can better understand the link between firefighting and cancer.

  1. International Agency for Research on Cancer. Volume 132: Occupational exposure as a firefighter. Lyon, France; June 7-14, 2022.
  2. About the NFR. Centers for Disease Control.
  3. Researchers Pin Down PFAS Prevalence in Firefighter Gear. NIST. May 2023.