{"id":2200,"date":"2026-03-27T12:47:50","date_gmt":"2026-03-27T19:47:50","guid":{"rendered":"https:\/\/blogs.ufv.ca\/chasi\/?p=2200"},"modified":"2026-03-27T12:47:50","modified_gmt":"2026-03-27T19:47:50","slug":"when-cancer-strikes-too-early-what-emerging-research-means-for-women-in-the-fire-service","status":"publish","type":"post","link":"https:\/\/blogs.ufv.ca\/chasi\/2026\/03\/27\/when-cancer-strikes-too-early-what-emerging-research-means-for-women-in-the-fire-service\/","title":{"rendered":"When Cancer Strikes Too Early: What Emerging Research Means for Women in the Fire Service"},"content":{"rendered":"<p><em>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\u00a0<a href=\"https:\/\/indigenousfiresafety.ca\/en\">National Indigenous Fire Safety Council<\/a>. His guest blog posts explore a wide range of topics related to firefighting and firefighters in Canada. You can read <a href=\"https:\/\/blogs.ufv.ca\/chasi\/tag\/len-garis\/\">all of his guest articles at this link<\/a>. This article was originally written for Firefighter Cancer Awareness Month in January.<\/em><\/p>\n<h2><strong>When Cancer Strikes Too Early: What Emerging Research Means for Women in the Fire Service<\/strong><\/h2>\n<p><em>Len Garis, Anna Wilkinson<\/em><\/p>\n<p>Every January, Firefighter Cancer Awareness Month asks the fire service to confront a difficult certainty: cancer remains the leading cause of line\u2011of\u2011duty death. Yet one group continues to sit at the edges of our data \u2014 female firefighters.<\/p>\n<p>Their numbers may be small, but the risks they face are not. And while the research base is still developing, early findings point toward a concerning pattern: some female firefighters are reporting cancer diagnoses at younger ages than expected in the general population, often before they qualify for routine screening. When these emerging signals are viewed alongside new evidence from the broader public, the implications for screening policy become increasingly difficult to ignore.<\/p>\n<p>This is not just a health issue. It is a workforce issue, a gender\u2011equity issue, and a matter of occupational justice.<\/p>\n<h3><strong>A Hidden Population With Distinct Exposure Patterns<\/strong><\/h3>\n<p>The 2022 study <em>Female Firefighter Work Related Injuries in the United States and Canada<\/em> surveyed more than 1,100 active female firefighters.<a href=\"#_ftn1\" name=\"_ftnref1\"><sup>[1]<\/sup><\/a> Although the study focused on injuries, it revealed a pattern relevant to long\u2011term health: women who reported injuries tended to be older, had more years in service, and had significantly more fires and toxic exposures.<\/p>\n<p>In other words, the longer women serve, the more they accumulate the exposures already linked to cancer in the broader fire service.<\/p>\n<p>The 2023 study <em>Cancer in Female Firefighters<a href=\"#_ftn2\" name=\"_ftnref2\"><sup>[2]<\/sup><\/a><\/em> provides additional insight, though with important limitations. Among 256 women who self\u2011reported cancer or precancerous conditions, researchers observed that:<\/p>\n<ul>\n<li>Women with cancer had more years in the fire service<\/li>\n<li>They reported higher numbers of career fires and toxic exposures<\/li>\n<li>They were less likely to remain in active service<\/li>\n<li>The average age at diagnosis for pre-cancerous lesions was 40.9<\/li>\n<li>The average age at diagnosis of cancer was 44.2<\/li>\n<\/ul>\n<p>This does not establish a population\u2011wide diagnosis age \u2014 the sample is small and self\u2011selected \u2014 but it does highlight a potential early\u2011onset pattern that warrants further investigation.<\/p>\n<h3><strong>New Age\u2011at\u2011Diagnosis Data: What We Can Reliably Interpret<\/strong><\/h3>\n<p>A recent analysis of self\u2011reported cancer and pre-cancer cases among female firefighters provides additional context. Because the sample size was small, only those types of cancers with ten cases or more are reported.<\/p>\n<h4><strong>Cancer Types With more than 10 Cases<\/strong><\/h4>\n<table>\n<thead>\n<tr>\n<td><strong>Cancer Type<\/strong><\/td>\n<td><strong>Number of Pre-cancers<\/strong><\/td>\n<td><strong>Average age at diagnosis of Pre\u2011Cancer <\/strong><\/td>\n<td><strong>Cancer N<\/strong><\/td>\n<td><strong>Average Age at Cancer Diagnosis<\/strong><\/td>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td>Breast<\/td>\n<td>21<\/td>\n<td>45<\/td>\n<td>37<\/td>\n<td>45<\/td>\n<\/tr>\n<tr>\n<td>Uterus<a href=\"#_ftn3\" name=\"_ftnref3\"><sup>[3]<\/sup><\/a><\/td>\n<td>31<\/td>\n<td>34.3<\/td>\n<td>12<\/td>\n<td>40.2<\/td>\n<\/tr>\n<tr>\n<td>Melanoma<\/td>\n<td>34<\/td>\n<td>39.7<\/td>\n<td>22<\/td>\n<td>45.1<\/td>\n<\/tr>\n<tr>\n<td>Other<\/td>\n<td>51<\/td>\n<td>39<\/td>\n<td>21<\/td>\n<td>39.3<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Even with these limitations, a pattern emerges: cancers appear to be occurring in women in their 40s and even 30s \u2014 many before our national recommendations suggest that routine screening begins.<\/p>\n<p>This reinforces what the earlier studies suggested: some female firefighters may be experiencing cancer earlier than expected, and current screening guidelines do not reflect the exposure realities of the job.<\/p>\n<h3><strong>The Screening Gap: When Eligibility Doesn\u2019t Match Occupational Reality<\/strong><\/h3>\n<p>In Canada, our national guidelines recommend that average risk breast screening begins at age 50, but almost all provinces now have access to screening starting at age 40 or 45. However, many breast screening programs for women aged 40-49 do not issue invitations or recall reminders, and so women must be aware and self-advocate to gain access. Cervical cancer screening begins at age 25, but access to HPV testing \u2014 the more accurate method \u2014 remains inconsistent across the country. Colon cancer screening starts at age 50, and lung cancer screening, which is also not available across the country, is considered in those individuals who have smoked a pack of cigarettes a day for about 20 years and are 55 or older.<\/p>\n<p>If some female firefighters are reporting cancer diagnoses in their 40s, then our national screening guidelines might not be aligned with occupational risk. While the current available research cannot yet quantify the true incidence or establish causation, it does warrant more research to expose \u00a0any potential mismatch between exposure and eligibility.<\/p>\n<h3><strong>New Evidence From the Public: Screening at 40 Improves Outcomes<\/strong><\/h3>\n<p>A 2025 study in <em>Radiology: Imaging Cancer<\/em> examined 821 breast cancer cases in women aged 40 and older.<a href=\"#_ftn4\" name=\"_ftnref4\"><sup>[4]<\/sup><\/a> It found that:<\/p>\n<ul>\n<li>Symptom\u2011detected cancers were 6.6 times more likely to be advanced stage<\/li>\n<li>Symptom\u2011detected cancers carried a 63% higher risk of breast\u2011cancer\u2011related death<\/li>\n<li>Women aged 40\u201349 \u2014 a group not routinely screened in many Canadian jurisdictions \u2014 had the highest proportion of symptom\u2011detected cancers<\/li>\n<li>Screen\u2011detected cancers were overwhelmingly early stage<\/li>\n<li>Mastectomy rates were significantly higher when cancers were detected due to symptoms<\/li>\n<\/ul>\n<p>Meanwhile, two studies with Statistics Canada found that women living in a province with an organised breast screening program for women 40-49 had earlier stage cancers at diagnosis, lower mortality and increased survival compared to provinces which did not have programs.<a href=\"#_ftn5\" name=\"_ftnref5\"><sup>[5]<\/sup><\/a><\/p>\n<p>The conclusion is clear: for the general population, starting screening at 40 improves outcomes.<\/p>\n<p>For a workforce showing signs of even earlier diagnoses, the implications are significant.<\/p>\n<h3><strong>What the Evidence Suggests \u2014 and What It Cannot Yet Tell Us<\/strong><\/h3>\n<p>The research on female firefighters is still emerging, and the sample sizes remain small. The cancer study relied on voluntary self\u2011reporting, which introduces selection bias and limits generalizability. These limitations matter \u2014 and acknowledging them strengthens, rather than weakens, the argument for action.<\/p>\n<h4><strong>What the evidence suggests:<\/strong><\/h4>\n<ul>\n<li>Female firefighters experience occupational exposures known to increase cancer risk<\/li>\n<li>Some are reporting cancer diagnoses at younger ages than the Canadian population<\/li>\n<li>The average reported age at cancer diagnosis falls below national screening guideline recommendations<\/li>\n<li>Broader population research shows clear benefits to earlier screening<\/li>\n<\/ul>\n<h4><strong>What the evidence cannot yet determine:<\/strong><\/h4>\n<ul>\n<li>The true incidence of cancer among female firefighters<\/li>\n<li>Whether the reported earlier diagnoses reflect a broader trend<\/li>\n<li>The precise relationship between exposures and cancer onset<\/li>\n<\/ul>\n<p>But in occupational health, waiting for perfect data has historically meant acting too late.<\/p>\n<h3><strong>Why Female Firefighters May Face Earlier or Elevated Cancer Risks<\/strong><\/h3>\n<p>Female firefighters encounter a constellation of carcinogenic and hormonal stressors:<\/p>\n<ul>\n<li><strong>Carcinogenic exposures:<\/strong> combustion by\u2011products, diesel exhaust, PFAS, flame retardants, building materials<\/li>\n<li><strong>Shift work and circadian disruption:<\/strong> linked to breast cancer through melatonin and estrogen pathways<\/li>\n<li><strong>PPE not historically designed for women:<\/strong> increasing exposure pathways<\/li>\n<li><strong>Station design and decontamination challenges:<\/strong> cross\u2011contamination risks<\/li>\n<li><strong>Cultural barriers to reporting symptoms:<\/strong> fear of being perceived as weak<\/li>\n<li><strong>Biological vulnerability:<\/strong> younger breast tissue is more sensitive to carcinogens<\/li>\n<\/ul>\n<p>These factors do not prove causation, but they do create a risk profile that differs from the general population and is not adequately addressed by current screening guidelines.<\/p>\n<h3><strong>What Earlier Screening Could Mean for the Fire Service<\/strong><\/h3>\n<p>If screening policies were aligned with occupational risk, the benefits could be substantial:<\/p>\n<ul>\n<li>Earlier detection and improved survival<\/li>\n<li>Less aggressive treatment<\/li>\n<li>Lower long\u2011term costs for employers and insurers<\/li>\n<li>Improved retention of experienced female firefighters<\/li>\n<li>A modern, evidence\u2011aligned safety culture<\/li>\n<\/ul>\n<p>The fire service has embraced decontamination, clean\u2011cab policies, and exposure tracking. Screening is the next logical step.<\/p>\n<h3><strong>A Precautionary, Evidence\u2011Aligned Recommendation<\/strong><\/h3>\n<p>Based on the emerging research and the broader screening literature, a reasonable, risk\u2011aligned screening approach for female firefighters could include:<\/p>\n<ul>\n<li>Breast cancer screening starting at age 40\n<ul>\n<li>Consideration of earlier initiation of screening based on family history (10 years prior to the age at diagnosis of the first degree relative)<\/li>\n<li>Consideration of high-risk screening if lifetime breast cancer risk &gt;25% <a href=\"https:\/\/ibis.ikonopedia.com\/\">https:\/\/ibis.ikonopedia.com\/<\/a><\/li>\n<\/ul>\n<\/li>\n<li>Colon cancer screening starting at age 45\n<ul>\n<li>Consideration of earlier initiation of screening based on family history (10 years prior to the age at diagnosis of the first degree relative)<\/li>\n<\/ul>\n<\/li>\n<li>Cervical cancer screening starting at age 25 with HPV screening<\/li>\n<li>Yearly skin exams<\/li>\n<li>Lung Cancer screening if eligible, starting age 55<\/li>\n<li>On\u2011duty access to screening and paid medical time<\/li>\n<li>Integration of screening into occupational health programs<\/li>\n<li>Expansion of presumptive legislation to include female\u2011specific cancers<\/li>\n<\/ul>\n<p>This is not preferential treatment. It is a precautionary, evidence\u2011informed approach to prevention.<\/p>\n<h3><strong>Honouring the Women Who Serve<\/strong><\/h3>\n<p>Female firefighters step into the same burning buildings, breathe the same smoke, and carry the same burdens as their male colleagues \u2014 often while navigating equipment, policies, and cultural expectations that were not designed with them in mind.<\/p>\n<p>They deserve screening policies that reflect the realities of their work, not the assumptions of the general population.<\/p>\n<p>Cancer does not wait for eligibility guidelines.<br \/>\nIt does not pause for policy debates.<br \/>\nIt does not care about age thresholds.<\/p>\n<p>If we want to honour the women who serve, we must ensure that the tools of prevention \u2014 especially screening \u2014 are aligned with the risks they face every day.<\/p>\n<p>Firefighter Cancer Awareness Month is the moment to say it clearly:<br \/>\n<strong>Female firefighters need earlier screening.<br \/>\nThey need better support.<br \/>\nAnd they need policies that reflect the risks of their profession.<\/strong><\/p>\n<p>The research may still be growing, but the direction is unmistakable.<\/p>\n<h3><strong><em>Authors\u00a0 <\/em><\/strong><\/h3>\n<p><em>Len Garis is director of research for the National Indigenous Fire Safety Council,<\/em><em> Ret.<\/em><em> Fire Chief for the city of Surrey, B.C., Research Associate \u2013 University of the Fraser Valley associate scientist emeritus with the B.C. Injury Research and Prevention Unit. Contact him at <\/em><a href=\"mailto:lwgaris@outlook.com\"><em>lwgaris@outlook.com<\/em><\/a><em>.<\/em><em>\u00a0<\/em><\/p>\n<p><em>Anna Wilkinson is <\/em><em>a family physician and GP Oncologist at the Ottawa Hospital. She is an Associate Professor in the Department of Family Medicine at the University of Ottawa, Program Director for the PGY-3 FP Oncology program and Regional Cancer Primary Care Lead. Contact: <\/em><a href=\"mailto:anwilkinson@toh.ca\"><em>anwilkinson@toh.ca<\/em><\/a><\/p>\n<p><a href=\"#_ftnref1\" name=\"_ftn1\"><sup>[1]<\/sup><\/a> Pawer S, Turcotte K, Desapriya E, et al. Female Firefighter Work\u2011Related Injuries in the United States and Canada: An Overview of Survey Responses. Frontiers in Public Health. 2022.<\/p>\n<p><a href=\"#_ftnref2\" name=\"_ftn2\"><sup>[2]<\/sup><\/a> Kunz KR, Turcotte K, Pawer S, et al. Cancer in Female Firefighters: The Clinicobiological, Psychological, and Social Perspectives. Frontiers in Public Health. 2023.<\/p>\n<p><a href=\"#_ftnref3\" name=\"_ftn3\"><sup>[3]<\/sup><\/a> Uterus may include Uterine and\/or Cervical cancers<\/p>\n<p><a href=\"#_ftnref4\" name=\"_ftn4\"><sup>[4]<\/sup><\/a> Munir J, Nisha Y, Islam N, et al. Impact of Method of Detection of Breast Cancer on Clinical Outcomes in Individuals Aged 40 Years or Older. Radiology: Imaging Cancer. 2025.<\/p>\n<p><a href=\"#_ftnref5\" name=\"_ftn5\"><sup>[5]<\/sup><\/a> <a href=\"https:\/\/www.mdpi.com\/1767156\">https:\/\/www.mdpi.com\/1767156<\/a>, <a href=\"https:\/\/doi.org\/10.1200\/JCO.23.00348\">https:\/\/doi.org\/10.1200\/JCO.23.00348<\/a><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>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\u00a0National 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 &#8230; <a title=\"When Cancer Strikes Too Early: What Emerging Research Means for Women in the Fire Service\" class=\"read-more\" href=\"https:\/\/blogs.ufv.ca\/chasi\/2026\/03\/27\/when-cancer-strikes-too-early-what-emerging-research-means-for-women-in-the-fire-service\/\">Read more<\/a><\/p>\n","protected":false},"author":232,"featured_media":2205,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"generate_page_header":"","footnotes":""},"categories":[5],"tags":[368,338,369,339,329],"class_list":["post-2200","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-research","tag-anna-wilkinson","tag-cancer","tag-female-firefighters","tag-firefighting","tag-len-garis"],"_links":{"self":[{"href":"https:\/\/blogs.ufv.ca\/chasi\/wp-json\/wp\/v2\/posts\/2200","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.ufv.ca\/chasi\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.ufv.ca\/chasi\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.ufv.ca\/chasi\/wp-json\/wp\/v2\/users\/232"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.ufv.ca\/chasi\/wp-json\/wp\/v2\/comments?post=2200"}],"version-history":[{"count":5,"href":"https:\/\/blogs.ufv.ca\/chasi\/wp-json\/wp\/v2\/posts\/2200\/revisions"}],"predecessor-version":[{"id":2207,"href":"https:\/\/blogs.ufv.ca\/chasi\/wp-json\/wp\/v2\/posts\/2200\/revisions\/2207"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blogs.ufv.ca\/chasi\/wp-json\/wp\/v2\/media\/2205"}],"wp:attachment":[{"href":"https:\/\/blogs.ufv.ca\/chasi\/wp-json\/wp\/v2\/media?parent=2200"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.ufv.ca\/chasi\/wp-json\/wp\/v2\/categories?post=2200"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.ufv.ca\/chasi\/wp-json\/wp\/v2\/tags?post=2200"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}