Study Uncovers Gaps in Skin Cancer Prevention Among Volunteer Firefighters

A study¹ published in the American Journal of Industrial Medicine found that among volunteer firefighters in the United States, there are gaps in skin cancer prevention efforts.

Firefighter Montreal/AdobeStock

Among firefighters, rates of melanoma incidence and mortality are higher than that of the general population.² This can be attributed to excess occupational exposure to ultraviolet rays and cancer-causing agents found in flame retardants.³ Due to this, the National Fire Protection Association explicitly recommends that firefighters undergo an annual skin cancer screening and skin check.

With this in mind, researchers Shah et al sought to examine skin cancer prevalence and prevention efforts among volunteer firefighters in the US, noting that these volunteers account for two thirds of the US fire service. Despite this statistic, skin cancer efforts and rates among this particular population have not yet been examined, and this study marks the first large-scale study to examine skin cancer screening efforts in this population of firefighters.

Researchers conducted a cross-sectional study wherein data from the Firefighter Cancer Assessment and Prevention Study (CAPS) was collected, stored, and assessed. Beginning in 2019, the ongoing CAPS study has prospectively assessed skin cancer risk and prevention efforts among volunteer firefighters. Researchers collected data from incumbent volunteer firefighters ages 18 years and older from 41 fire departments across multiple states (n=552). Firefighters with a history of skin cancer were excluded from study participation. Participants were defined based on having received a skin examination involving screening for skin cancer.

Study characteristics were divided fire service, employment, and sun protection characteristics. After consenting to participating, participants completed an online health survey asking questions pertaining to:

• Cancer screening practices
• Employment
• Fire service experience
• Health behaviors
• Personal and family cancer history

“Odds of receiving screening had a positive exposure-response relationship with responding to more monthly firefighting calls and was positively associated with having a family history of skin cancer,” according to Shah et al. “We did not observe an association between receiving screening and years of firefighting or with cancer risk perception.”

Of all participants, only 26.1% reported that they received a skin cancer screening.

“Only a quarter of volunteer firefighters had skin cancer screening, despite screening recommendations and higher risk of melanoma,” study authors wrote. “Additional assessment of skin cancer control and prevention practices within volunteer fire departments will help to address gaps in cancer screening among this understudied firefighter population.”

References

1. Shah NN, Steinberg MB, Caban‐Martinez AJ, et al. Prevalence and predictors of skin cancer screening among a sample of US volunteer firefighters. AmJ Ind Med. Published online August 12, 2023. doi:10.1002/ajim.23524
2. Jalilian H, Ziaei M, Weiderpass E, Rueegg CS, Khosravi Y, Kjaerheim K. Cancer incidence and mortality among firefighters. Int J Cancer. 2019; 145(10): 2639-2646. doi:10.1002/ijc.32199
3. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Painting, firefighting, and shiftwork. 2010. International Agency for Research on Cancer. World Health Organization. IARC monographs on the evaluation of carcinogenic risks to humans. International Agency for Research on Cancer; Distributed by WHO Press: viii, 804.