Cancer incidence and mortality in firefighters: A state-of-the-art review and meta-analysis

Elpidoforos S. Soteriades, Jaeyoung Kim, Costas A. Christophi, Stefanos N. Kales

Research output: Contribution to journalReview articlepeer-review

56 Citations (Scopus)


Objective: A systematic literature review and meta-analysis was conducted on the association between firefighting and cancer. Methods: A comprehensive literature search of databases including Medline, EMBASE, Biosis, NIOSHTIC2, Web of Science, Cancerlit, and HealthStar, for the period between 1966 to January 2007, was conducted. We also retrieved additional studies by manual searching. Results: A total of 49 studies were included in the meta-analysis. We found statistically significant associations between firefighting and cancers of bladder, brain and CNS, and colorectal cancers, consistent with several previous risk estimates. We also found statistically significant associations of firefighting with non-Hodgkin's lymphoma, skin melanoma, prostate, and testicular cancer. For kidney, Hodgkin's lymphoma, leukemia, lymphosarcoma and reticulosarcoma, multiple myeloma, and pancreatic cancer, we found some statistically significant but less consistent results. For all other cancers evaluated (esophageal, laryngeal, oral and pharyngeal, liver and gallbladder, lung, lymphatic and hematopoietic, non-melanoma skin cancer, stomach, and urinary cancer) we did not find any statistically significant associations. Conclusions: Although our meta-analysis showed statistically significant increased risks of either cancer incidence or mortality of certain cancers in association with firefighting, a number of important limitations of the underlying studies exist, which, precluded our ability to arrive at definitive conclusions regarding causation.

Original languageEnglish
Pages (from-to)3221-3231
Number of pages11
JournalAsian Pacific Journal of Cancer Prevention
Issue number11
Publication statusPublished - 2019


  • Cancer incidence
  • Firefighters
  • Meta-analysis
  • Mortality
  • Review

ASJC Scopus subject areas

  • Epidemiology
  • Oncology
  • Public Health, Environmental and Occupational Health
  • Cancer Research


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