Since the last century, researchers have conducted numerous meta-analyses and systematic reviews to investigate the association between firefighters and cancer. However, discrepancies persist due to variations in exposure, location, periods, analysis of cancer types, and study designs. Despite attempts to determine cancer risk and the minimal employment duration required for disease development, conclusions vary across studies.
Recent studies have presented conflicting results regarding cancer incidence among firefighters. The complexities of cancer site measurement, exposure, and geography further complicate the assessment of cancer incidence and mortality among firefighters.
Hence, this systematic review, funded by, and delivered in partnership with, the Ministry of Housing, Communities and Local Government (MHCLG), aims to contribute to the ongoing debate by investigating the association between firefighting occupation and cancer incidence and mortality. The primary objective is to study cancer incidence and mortality among firefighters worldwide compared to the general population. Additionally, secondary objectives include identifying significant findings, assessing source reliability, studying recent scientific developments, exploring areas of controversy, and identifying gaps in existing findings.
The results are divided into cancer incidence and mortality. While some studies report similar cancer incidence rates between firefighters and the general population, others identify significantly elevated risks for specific cancer types. Similarly, variations in cancer mortality rates are observed among firefighters compared to the general population. Our research shows there is consistent and robust evidence of increased incidence of skin melanoma, prostate, bladder, testicular, and colon cancer. On the other hand, there is evidence of increased mortality from rectal and non-Hodgkin’s lymphoma for firefighters when compared to the general population.
Limitations of the studies include the limited inclusion of female cohorts and, when included, the limited number of female subjects that are part of the cohorts, potentially affecting generalizability to women firefighters and generating discrepancies related to sex as a mediator for cancer risk and mortality. Furthermore, none of the studies included an analysis of incidence or mortality by incorporating demographic information such as race, ethnicity, or age.
This systematic review highlights the agreements and discrepancies in the occupation risk of firefighting for cancer incidence and mortality according to the most recent systematic reviews and meta-analyses. Further research is needed to address methodological challenges and provide more conclusive evidence regarding the association between firefighting occupation and cancer risk.