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Occupational Cancer in the Fire Service

Training, resources and best practices for preventing occupational cancer in the fire service.
Dr. Kannler and Abby Baker with Everett firefighters after cancer screenings.
Dr. Christine Kannler and MFA Program Coordinator Abby Baker with Everett firefighters after cancer screening.

Firefighters have much higher rates of cancer than the residents they serve. This is due to carcinogen exposure:

  • on the fireground. Especially in fires where plastics and synthetics release harmful gases;
  • and in the firehouse from diesel exhaust and residual soot.

Firefighters can unknowingly pass carcinogens on to their fellow firefighters and loved ones. 

Yet, cancer in firefighters is not inevitable. There are protective actions that all ranks of the fire service can take to decrease the risk of cancer. These include increasing awareness, early detection and enhancing protection. The Massachusetts Fire Academy (MFA) offers cancer awareness programs and early detection cancer screenings.

Table of Contents

Free Cancer Awareness Training and Screenings

Training Program - Taking Action Against Cancer in the Fire Service

The Firefighter Cancer Support Network (FCSN) developed this 3-hour course. Firefighters can take the course at their department or virtually. To sign up for the online program, use the LMS. For an in-person program, contact our coordinator.  This course provides three (3) OEMS credits, two (2) FCC credits, and one (1) FPO credit.


CT Scan

Studies show that a low-dose CT screening detects many health issues at early stages. And early treatment can be more effective. To be eligible for a free chest CT scan through the MFA, you must meet the following criteria:

  • be a Massachusetts resident;
  • have been a Massachusetts firefighter for at least 10 years;
  • be at least 40 years old;
  • have attended an MFA skin cancer screening (SCA), or a Taking Action Against Cancer in the Fire Service (422) class in the past three years;
  • provide MFA with the name, telephone number and fax of your current primary care provider (PCP);
  • answer questions truthfully and electronically sign a waiver. 

After approval, you make an appointment with our vendor and print a voucher from the LMS to give to the vendor. The scans are free.

For questions, please contact DFS.CancerScreening@mass.gov.


Skin Cancer Screening

Dr. Christine Kannler and volunteer dermatologists provide free skin cancer screenings. They use the SPOT Skin Cancer® program through the American Academy of Dermatology (AAD).

Dr. Christine Kannler talks about Skin Cancer and the Fire Service in this video.

Find a Screening
Search the LMS catalog for SCA-Skin Cancer Screening-Taking Action Against Cancer in the Fire Service. Sign up through the LMS. Or, use the form below to request a screening at your firehouse.

Firefighter Skin Cancer: A Screening Success Story


PSA (Prostate Specific Antigens) Blood Test

Studies show that firefighters get prostate cancer earlier than the general public. To be eligible for a free PSA blood test, you must meet the following criteria:

  • be a Massachusetts resident;
  • have been a Massachusetts firefighter for at least 10 years;
  • be at least 40 years old;
  • have attended an MFA skin cancer screening, or a Taking Action Against Cancer in the Fire Service (422) class in the past three years;
  • provide MFA with the name, telephone number and fax of your current primary care provider (PCP);
  • answer questions truthfully and electronically sign a waiver. 

Information about Firefighters and Prostate Cancer

The blood test is free through Massachusetts Fire Academy


Oral Cancer Screening

Request an oral screening with the form below. A dental hygienist can come to departments to provide the screenings. This screening often accompanies the skin cancer screening. The screening is free.


Request a Cancer Program or Screening

Request any of the cancer programs with this request form



National Firefighter Cancer Registry



Information and Statistics About Cancer in the Fire Service

The first step to preventing cancer is changing the culture in the firehouse. Soot laden turnout gear and helmets can no longer be viewed as a badges of honor. Firefighters can take the following measures immediately to help protect themselves from carcinogens. After every exposure to smoke:  

  • Use your SCBA (self-contained breathing apparatus) during overhaul.

  • Wipe your skin – especially the neck and face - with decontamination wipes as soon as possible after the exposure.   

  • Remove as much soot and particulates as possible from gear and equipment (gross decontamination).   Firefighters absorb harmful chemicals through their skin.

  • Change your clothes and wash them immediately after a fire.

  • Shower thoroughly after a fire.

  • Incident commanders can keep mutual aid coverage and call backs until the duty shift completes the measures above.

  • Wash structural gear and PPE after each fire in an approved gear extractor. This includes hoods, gloves, and helmet liners. Use a qualified contract service if you can't access an approved gear extractor.  Air dry gear or use an approved gear dryer.  

  • Thoroughly clean/decontaminate helmets (inside and out), boots, SCBA, radios, hand lights, etc.

  • Thoroughly clean/decontaminate the inside of the cab and riding positions on the fire apparatus.

  • Have a vigorous athletic workout within 12 hours; this helps rid the body of contaminants.

  • Use diesel exhaust extraction systems.

  • Store PPE away from apparatus floor.

  • Transport structural gear/PPE in a personal vehicle ONLY if: it is in a vapor tight bag; in the trunk of a car or bed of a truck. Never transport in the passenger compartment.   

  • Get an annual comprehensive firefighter physical exam with emphasis on cancer screening.

  • Document any exposures you may have.  (NFORS has an app you can put on your phone to track exposures).

  • Always avoid cross contamination. Never allow structural gear/PPE in living quarters.

Alarming Statistics

The Firefighter Cancer Support Network (FCSN) published Taking Action Against Cancer in 2013. The white paper covers firefighter cancer. It includes:

  • prevention;
  • diagnosis;
  • treatment;
  • and long term implications for the firefighter, firefighters’ family, co-workers, and community.

The research shows that firefighters are at greater risk than the general public for these cancers:

  • testicular cancer (2.02 times greater risk);
  • multiple myeloma (1.53 times greater risk);
  • non-Hodgkin’s lymphoma (1.51 times greater risk);
  • skin cancer (1.39 times greater risk) ;
  • malignant melanoma (1.31 times greater risk);
  • prostate cancer (1.28 times greater risk);
  • brain cancer (1.31 times greater risk);
  • colon cancer (1.21 times greater risk);
  • leukemia (1.14 times greater risk);
  • and breast cancer in women (preliminary results). 

The study demonstrates that cancer is an under-recognized threat to the health of firefighters.

You can read and download a copy of the study here: firefightercancersupport.org.


Resources for Firefighters

Resources for Dermatologists

Supplies for Use in Skin Cancer Screenings

Massachusetts Fire Academy Firefighter Skin Screening Guide

What to Discuss with Firefighters Before A Screening

Video of Supply Kit 


     FSTAR Firefighter Physicals Provider's Guide

     11 Ways to Prevent Cancer

     Firefighter Exposure Tracking APP Information - How to Download and Use

Additional Resources

Screening Firefighters for Skin Cancer - An Invitation to Dermatologists

SPOT Skin Cancer Screening Program Guidelines

American Academy of Dermatology (AAD) Toolkit

Melanoma Early Detection Guide

Carcinogenicity of Occupational Exposure as a Firefighter

Dermatologist Inspired to Screen Firefighters for Skin Cancer

Peter Kannler was a 37-year-old firefighter when he died of esophageal cancer in 2016. Dr. Christine Kannler is his sister. She said, "I couldn't save my brother but I can help save others by providing early screening." Watch the video, below to hear her story.

Resources for Physicians

The Occupational Risks of Being a Firefighter - UMass Chan Medical School Grand Rounds (5/2022)

With Michael G. Hamrock, MD and Benjamin Eovaldi, DO


Cancer in the Fire Service - Boston University Medical Center Internal Medicine Grand Rounds (10/2022)

With Christine Kannler, MD, MPH, FAAD, FACM 


Additional Resources

Provider's Guide to Firefighter Medical Evaluations

Cause of Increased Risk in Cancers and Cardiovascular Disease - Michael Hamrock, MD

Carcinogenicity of Occupational Exposure as a Firefighter

Success Stories

PJ Roy

Captain Patrick “P.J.” Roy, Ladder Co. 3, Fitchburg Fire Department, MFA Instructor of Taking Action against Cancer in the Fire Service

When I was asked to join the cancer awareness team at the Department of Fire Services (DFS), I was excited to spread the word about the most dangerous under-recognized threat to firefighters - cancer! My father was a Fitchburg firefighter. He passed away at age 62 from occupational cancer. His death motivated me to spread the word about early cancer detection and prevention to as many firefighters as I could reach. 

DFS offers many free cancer screenings. One of the newer screenings  is a CT scan. I knew this was an important test, but I was terrified about getting it!

I had been involved in promoting cancer awareness and screening to other firefighters for more than 5 years, but I was so worried about the CT scan that  I talked myself out of  getting it. I was afraid the scan would detect something, maybe something that would prevent me from firefighting.  But, I continued to think about it. “What if they find a cancer but treat me early. I would be back at work and healthy!” I also thought, “This scan could have saved my father! He could have met his grand kids and been around for his family.” I realized that getting the test was a no brainer!

I had the test. Luckily, my scan was clear. I know firefighters whose scans found cancers. But, they were found early and treated and these people are now healthy.

DFS has one of the best cancer awareness and screening programs in the country.  Massachusetts firefighters can take advantage of education and screenings to stay aware of the cancer epidemic in the fire service and to stay healthy.

His Father's Son - In this video, Captain Roy talks about the loss of his firefighter father to occupational cancer.


Lieutenant Michael Soltys, Boxford Fire Department

My first thought when I heard about free CT scans for cancer screening was, “Why not? It’s free.”

Lt. Michael Soltys

So I signed up for the CT scan and  a calcium test.  After I signed up, new thoughts came into my mind. “What if my calcium score shows signs of heart issues and I have to leave firefighting?”  That thought stuck with me.  I almost canceled several times for fear that my career in the fire service might be over. 

Test results showed an excellent calcium score, but the scan showed a 5.5 cm mass on my thyroid.  That was not the news I was expecting. I never considered that the CT scan would reveal anything. I consulted with several doctors and decided to remove half of my thyroid.  After the surgery, tests showed that the mass was not cancerous.   When the doctor gave me this news, I asked, “What if the mass was not detected?” The doctor said, “We don’t know.” I’m relieved that I know the mass isn’t cancerous. Not knowing about it is a chance I would not want to take. If the free CT scan was not offered to me, I might have had far more serious issues than the loss of half my thyroid.  I can’t say it enough, “This test was so important for me and my family!”

The month between the CT scan results and learning that the mass was benign felt like years. It was an emotionally overwhelming time.  The support that I received from DFS and the IAFF was phenomenal.   I urge everyone in the Fire Service to take advantage of the free cancer screenings from DFS and the IAFF.

Deputy Chief Michael Donoghue, Chelmsford Fire Department

Deputy Chief Michael Donoghue

I was fortunate to take part in the cancer screenings offered by DFS. First, I had the skin cancer screening. The doctor found a spot on my head and referred me for further testing. Luckily, the spot was benign. I will have a follow-up screening in one year.

Next, I signed up for the CT scan and paid $100 for the calcium score. According to my doctor, the CT scan was ok, but I had a high calcium score and I was referred to a cardiologist for further evaluation. I had an ultrasound and a stress test. As a result, the cardiologist made minor modifications to my medicines. I was, and still am, completely asymptomatic. I will now see the cardiologist each year.  

The early detection programs offered by DFS are an asset to the fire service if people take advantage of them. I encouraged all my members to take part. I especially encouraged older firefighters. I'm an “older” firefighter at age 55, beginning my 28th year with the fire service. 

Chief Daniel Stamborski, Chicopee Fire Department

Chief Daniel Stamborski, Chicopee Fire Department

DFS cancer screenings are an amazing opportunity for every firefighter. I’m a 25-year veteran of the fire service. Over time I’ve found that you must be proactive about your health or many issues can be dismissed or overlooked.

Annual physicals are minimal. Most take only a few minutes and include the most basic examinations. If your doctor is on the ball, you may have some basic blood work. For several years, I had an excellent primary care doctor. I was able to educate him about my occupational risks based on a DFS class. The instructor provided a checklist to share with doctors – it listed all the tests a firefighter should have. My doctor used the list to get me regular chest x- rays and additional blood work each year.

13 years ago I lost my father, a 28-year veteran firefighter, to bladder cancer. My doctor explained that bladder cancer is occupational, not hereditary. He recommended a very inexpensive urine test that I had to pay for. This ought to be a standard test for all firefighters.  

I commend DFS for the effort to build awareness and to offer information and screening about occupational cancer in the fire service. I think that state government should push for thorough physicals that mirror those the state HazMat team gets. Full body scans at a group discount are another good idea. There are countless stories of the benefits of these scans. I paid for my own after my father passed and it was $500.00. Negotiating a state group rate could bring that cost down.

Recently, I had a CT screening through the DFS program. They found spots on my lower lungs that led to an asthma diagnosis. I am being treated and I feel much better. The scan also identified an enlarged thyroid that my doctor is monitoring. I applaud the efforts of DFS. The cancer screenings and awareness training will undoubtedly save some lives. Everyone should take advantage of the programs.

Captain Phil Rogers

Captain Phil Rogers, Chelsea Fire Department

I'm 51 and have been a member of the fire service since 1993.  I had both the CT scan and the skin cancer screening and I had a wonderful and painless experience.  I had one mole removed from my nose which was non-cancerous. I highly recommend the screenings for every firefighter.  Too many of us are dying from cancer on the job and after we retire.  Anything we can do to reduce that chance should be done. 

My only problem with the DFS screening program is that it doesn’t have more screenings.  A firefighter’s chance of getting many different cancers is substantially higher than the general population.  The more types of cancer we are screened for, the better chance of finding and treating the cancer.

Firefighters need better communication with our primary care physicians. We have to educate them about the cancer risks to firefighters. When I speak with physicians about my work and occupational risks, I often think that they don't understand. Sometimes their attitude is, "I’m the MD, not you.  What do you know?" I know that I’ve lost many friends and co-workers to cancer and that many more had their lives turned upside down by cancer.  That's what I know..

I want to thank Dr. Kannler and all of the other physicians and nurses in the program for the wonderful way you treat us.  Your kindness, compassion and professionalism has not gone unnoticed.

On a personal note, Dr. Kannler's late brother Pete was my friend. There is no better way to honor Pete and all the other like him than to get involved in programs like this. Sign up for your screenings soon.

Albert B. Beardsley, Program Coordinator, Advanced Fire Skills, Massachusetts Firefighting Academy

Albert B. Beardsley, Program Coordinator, MFA

In February 2023, I participated in a free skin cancer screening with Dr. Christine Kannler. The screening was fast and easy but the doctor found some areas on my ears that needed further attention. The next step was calling my dermatologist. I must say it was a quick and painless process.

When I called, the receptionist said that the first appointment available was in July, five months away. I told the receptionist that I had had a skin cancer screening with the Cancer in the Fire Service program with Dr. Kannler. Suddenly I was pushed to the head of the line and the doctor contacted me the next day! Wow, that's what I call service! All joking aside, the Cancer in the Fire Service screening program is really having an impact in the field when all you need to do is mention a name and the tone completely changes. 

Thanks again to both Abby Baker and Dr. Kannler for providing this service. I knew that I had a couple of areas of concern on my back but the spots on my ears that the screening identified really surprised me. A "tip-o-the-helmet" to both of you!


Firefighter Joanie Cullinan, Wellesley Fire Department

In this video, FF Joanie Cullinan and Dr. Christine Kannler talk about a free skin cancer screening that saved FF Cullinan's life. Saving Lives with Early Detection - One Firefighter's Story.  




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