This article is part of a series of posts led by CHASI Research Associate Len Garis, who has been a long-time partner of CHASI through his work with the National Indigenous Fire Safety Council. His guest blog posts explore a wide range of topics related to firefighting and firefighters in Canada. You can read all of his guest articles at this link.
By Len Garis and Todd Schierling
The Cost of Waiting: Managing Cancer Risk in Canada’s Fire Service
Cancer has become one of the most significant occupational challenges facing the Canadian fire service. While firefighters have always accepted the immediate dangers of the job, the long‑term health consequences of repeated exposure to toxic environments are now emerging with greater clarity — and urgency. As the original analysis notes, “cancer has become the leading cause of line‑of‑duty death for firefighters,” a reality that is reshaping how departments, municipalities, and compensation systems think about long‑term health protection.
This is not simply a medical issue. It is a question of risk management, organizational maturity, and how systems adapt when evidence shows that the stakes are higher than previously understood.
A Growing Burden, Now Quantified
WorkSafeBC data covering the period 2020 to 2025 provides one of the clearest pictures to date of the cancer burden facing firefighters. Over this five‑year span, more than 300 cancer claims were accepted for career, volunteer, and paid‑on‑call firefighters. When viewed against the size of the fire service, this translates to approximately one in every 50 firefighters being diagnosed with cancer during that period — the equivalent of about four cases per 1,000 firefighters each year. It is a rate that underscores how deeply occupational exposure is shaping long‑term health outcomes in the fire service.
The cancers identified in these claims reflect the spectrum of hazards firefighters face. Among the most frequently occurring were pancreatic cancer, brain cancer, lung cancer, and multiple myeloma — cancers that are often detected late and carry high fatality rates. The document underscores this point directly: “Many were advanced, aggressive, or fatal.” Where staging information was available, a significant proportion of cases were diagnosed at Stage III or Stage IV, particularly among pancreatic and lung cancers.
This pattern aligns with what many departments have observed anecdotally for years. The data now confirms it: firefighters are developing serious cancers at a rate that cannot be dismissed as incidental or expected. It is a systemic risk, not an individual anomaly.
Uneven Access to Screening Across the Country
A 2025 survey of British Columbia’s 55 career fire departments revealed a wide variation in how departments approach cancer screening. Some have invested in dedicated, occupation‑specific screening programs. Others rely on general medical assessments that may not address the unique risks associated with firefighting. And a substantial number have no structured screening program at all.
This variation is not tied to differences in exposure. It reflects differences in local resources, administrative capacity, and negotiated benefits. The result is predictable: firefighters in some communities have access to early detection, while others do not.
For volunteer and paid‑on‑call departments — often operating with limited budgets and administrative support — the gap is even wider. Yet the risk is the same. As the document notes, “a firefighter’s access to life‑saving early detection is often determined by their location and status.”
A Precedent for Monitoring Known Hazards
The fire service does not need to look far for a model of how occupational health risks can be monitored consistently. WorkSafeBC’s hearing‑test requirements under Occupational Health and Safety Regulation 7.8 mandate initial and annual hearing tests for workers exposed to noise hazards. The rationale is simple: if exposure is predictable and the risk is quantifiable, then monitoring worker health is part of responsible risk management.
Carcinogenic exposure in firefighting meets that same threshold.
The question is not whether screening is a benefit — it is whether screening is a reasonable and necessary component of managing a known occupational hazard.
The Financial and Operational Consequences
The compensation data illustrates the broader impact of firefighter cancer. Over the five‑year period examined, the total cost of allowed cancer claims for male firefighters alone exceeded $37 million. Healthcare costs accounted for more than $8.2 million, while long‑term disability and wage‑loss benefits added another $3.5 million. The most sobering figure is the nearly $22 million paid in survivor benefits — a reflection of the fatality rates associated with late‑stage cancers.
These figures represent only the direct costs. They do not capture the operational strain created when experienced members are off work for treatment, the overtime required to maintain staffing, the recruitment and training of replacements, or the long‑term pension impacts of early mortality. Nor do they reflect the profound disruption experienced by families. As the document states, “the true cost of firefighter cancer is far greater than what appears in compensation data.”
For municipalities and fire departments, this is not just a health issue — it is a workforce stability issue.
Why Early Detection Matters
Early detection is not simply a clinical intervention. It is a risk‑mitigation strategy that strengthens organizational resilience.
When cancers such as pancreatic, lung, or multiple myeloma are detected early, treatment options expand dramatically. Survival rates improve. Time away from work decreases. Families experience less disruption. Departments face fewer operational pressures. And compensation systems avoid the high costs associated with late‑stage disease.
In other words, early detection protects people and stabilizes systems.
A National Opportunity
Canada now has an opportunity to move toward a more consistent, trusted approach to firefighter cancer screening — one that reflects the realities of modern firefighting and the expectations of a mature safety culture.
A coordinated framework does not need to be prescriptive or burdensome. It can be built around principles that already guide occupational health: consistency, accessibility, integration, shared responsibility, and data stewardship.
Such a framework would not replace local autonomy. Instead, it would ensure that every firefighter — regardless of where they serve — has access to meaningful early detection.
Conclusion: Managing Risk Before It Manages Us
The evidence is clear. Firefighters across Canada are developing cancers at rates that carry significant human, financial, and operational consequences. These outcomes are not inevitable. Earlier detection and more consistent screening practices offer a practical path to reducing harm, supporting families, and strengthening the resilience of fire departments nationwide.
Firefighters show up for their communities every day. A thoughtful, coordinated approach to cancer screening is one way the system can show up for them in return.
Authors
Len Garis is Fire Chief (ret) for the city of Surrey, B.C., Research Associate – University of the Fraser Valley, and associate scientist emeritus with the B.C. Injury Research and Prevention Unit. Contact him at lwgaris@outlook.com.
Todd Schierling is the president of the BC Professional Firefighters Association, a captain with the Surrey Fire Services and an IAFF 6th District field service representative. Contact him at president@bcpffa.org.