Taking Control: Your Guide to Cancer Screening and Risk Reduction
Clear facts on your risk of cancer, screening tools, and the critical importance of a proactive lifestyle
For too long, cancer has been considered an unavoidable risk of the job. But as Station Two Clinic medical director Dr. Marcie Hamrick recently discussed in our podcast on fire fighters and cancer, the conversation around fire fighter cancer is shifting from resignation to action. By understanding the true nature of your risk and committing to proven screening methods and on-the-job discipline, you can take meaningful steps to protect your health and future.
This guide, based on Dr. Hamrick’s insights, cuts through the noise to give you the clear facts on elevated risk, the most effective screening tools, and the critical importance of a proactive lifestyle.
The Hard Facts on Elevated Risk
The science is clear: Fire fighters face an elevated risk of cancer. Studies say different things, but overall, it’s believed that fire fighters have a 9% higher risk of a cancer diagnosis and about 14% higher risk of a cancer-related death.
What does it mean when scientists say, “Fire fighters have a 9% increased risk of a cancer diagnosis?” The increase is compared to the general population. So let’s say that in one year, 70 U.S. residents in every 10,000 get a cancer diagnosis. Then, a 9% increase would mean that about 76 fire fighters get a cancer diagnosis. It’s important to remember that an “elevated risk” doesn’t translate into a “guarantee.”
The information below provides additional insight into the risks fire fighters face.
- Testicular Cancer: Fire fighters face about twice the risk of the general male population, moving the lifetime incidence from 4 out of 1,000 to 8 out of 1,000.
- Prostate Cancer: The risk is 1.25 times higher than the general male population, increasing the lifetime incidence from 125 out of 1,000 to 156 out of 1,000.
- Breast and Cervical Cancer: Female fire fighters may face a higher risk of developing breast and cervical cancer than the general female population, although the connection between fire fighting and cancer is less clear due to the small number of female fire fighters. There is some data that shows female fire fighters are diagnosed with cancer at a lower age than the general population, but again, the data isn’t conclusive.
This elevated risk stems from two main factors that, together, create a “double whammy.”
1. Occupational Exposure
The primary driver of the increased risk is exposure to carcinogens in smoke, exhaust, and chemicals, including those historically used in fire fighting foam. Dr. Hamrick emphasizes that the risk is demonstrably higher for those who have responded to more fires in their careers, pointing directly to exposure as a major culprit.
2. Lifestyle Factors
Genetics plays a smaller role in cancer risk—only about 10-20%. The remaining 80-90% is often driven by a combination of occupational and lifestyle factors. These are areas you can actively change:
- Sleep deprivation
- Alcohol use
- Obesity
- Eating excessive red meat, particularly processed red meat
Proven Shields: Risk Reduction and Standard Screening
You have the power to influence both your on-the-job exposures and your lifestyle choices.
Actionable Steps on the Job
The most significant impact you can have starts with immediate changes to your post-fire protocol:
- Full PPE, Always: Use full Personal Protective Equipment (PPE) throughout the entire incident, including wearing a Self-Contained Breathing Apparatus (SCBA) during salvage and overhaul.
- Immediate Decon: Perform gross decontamination of your PPE immediately after coming out of a fire.
- Wipes Work: Use baby wipes on your head and neck immediately after exiting a fire. This simple habit is scientifically proven to work. Dr. Hamrick notes: “I recently read a study that showed a 58% reduction in carcinogen levels in the blood of firefighters between those who used the baby wipes versus those who didn’t.”
- Cleanliness is Critical: Shower as soon as possible and properly store your PPE away from living and common areas. The culture is changing—a pristine helmet is a sign of a professional taking care of their health.
Standard Screenings That Save Lives
While newer tests grab headlines, the highest-yield, tried-and-true methods are the screenings already recommended. These are the tools proven to reduce mortality.
The most crucial takeaway: Do not skip your Annual Fire Fighter Medical Evaluation (AFFME) and follow up on every referral. Early detection is most effective when you feel fine—that’s when cancer is most treatable.
Screenings currently offered through Station 2 Clinic and similar programs include:
- Lab Work: Blood testing (for blood cancers like multiple myeloma), PSA testing (for prostate cancer), and a urine sample (for bladder and kidney cancer).
- Colon Cancer Screening: Recommended to start at age 40 (earlier than the general population) and can be done via an annual stool test or a colonoscopy every five years.
- Targeted Screening: Lung imaging to evaluate for mesothelioma. This is not a very common cancer, but it is a particularly bad type of cancer.
- Physical Exam: A thorough check, including skin, lymph nodes, and palpation of the thyroid gland.
- For Women: Mammograms starting at age 40 and up-to-date Pap smears.
The Catch: Advanced Screening—Proceed with Caution
It’s natural to be interested in new, advanced screening options like the Gallery Test, whole-body MRI, or whole-body ultrasound. They sound attractive because they promise to screen for many cancers at once. However, these tests currently come with significant drawbacks, often leading to more anxiety and unnecessary testing without a proven life-saving benefit.
Dr. Hamrick advises caution: “Overall, I would say they tend to result in the over-diagnosis and over-treatment of conditions and abnormalities that may not cause people any problems at all. They may provide false reassurance. The tests generally recommended by the NFPA, such as colonoscopy, blood tests, and mammograms, are tried and true. We know that they save lives if we do them.”
| Screening Option | The Problem |
|---|---|
| Multi-Cancer Early Detection Blood Testing (e.g., Galleri Test) | Poor at catching early-stage cancer. The Galleri test only picks up Stage 1 cancer 16% of the time. While it’s highly accurate for advanced cancers, there is no evidence yet that it reduces mortality. |
| Whole-Body MRI | Too many incidental findings. Ninety-five percent of people who get one have at least one abnormality, and 91% of those are not clinically relevant—meaning they lead to stressful, costly, and invasive follow-up procedures for nothing. |
| Whole-Body Ultrasound | Similar to MRI, it is inexpensive and radiation-free, but it has a high rate of false positives and has not been shown to confer a proven mortality benefit. |
Research is actively being done to look at these cancer screening methods, specifically among fire fighters to help determine the risks and benefits in this population. The higher the cancer risk in a group, the more likely it is that the benefits outweigh the risks. Dr. Hamrick and the Station 2 Clinic clinicians are monitoring the results of this research and looking for opportunities to participate in relevant studies.
Your Strongest Move Against Cancer
If you are considering any advanced cancer screening, discuss it with your Station 2 Clinic provider during your AFFME or in a follow-up visit. Go into the conversation prepared to review your personal risk factors (family history, occupational history) and to learn about the follow-up road you may face if an abnormality is found.
Your strongest move against cancer is clear and in your control: Focus on proven on-the-job safety measures, prioritize lifestyle changes, and above all, follow through with your AFFME and all recommended standard cancer screenings.