Firefighter Lung Health: an Impetus for Lung Cancer Screening Program Development

Firefighters face significant occupational exposure to carcinogenic substances, including those found in wildfire and structural fire smoke. Despite growing evidence linking firefighting to increased lung cancer risk, no occupationally tailored lung cancer screening guidelines exist. This study aims to assess firefighters' perspectives on lung health and screening to inform the development of targeted screening programs. A cross-sectional survey was conducted among 60 firefighters in the San Francisco Bay Area. Participants provided demographic and occupational exposure data, and attitudes toward lung cancer screening were assessed using a validated questionnaire. Logistic regression was used to analyze factors associated with favorable screening attitudes. The majority (95%) expressed willingness to undergo lung cancer screening, and 98% believed screening saves lives. Younger firefighters and those actively serving were more likely to favor screening (p = .031 and < 0.001, respectively). Greater exposure to wildland fires in the past year was associated with a 3.4 times increased likelihood of screening favorability (p = .036). In contrast, prior smokers were less favorable toward screening (p < .001). Firefighters demonstrate a high level of receptivity toward lung cancer screening, with younger and more recently exposed individuals showing greater engagement. These findings highlight the need for tailored lung health initiatives and targeted education, particularly for older and former smokers. Developing firefighter-specific screening protocols could enhance early detection and improve long-term health outcomes in this high-risk population.