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Cancer Screening

Firefighter Skin Cancer Screening Tool KiT

The Firefighter Cancer Support Network is honored to be working with the American Academy of Dermatology (AAD) to reduce the impact of skin cancer in the fire service through screenings.
Using a model that began in 2017 by board-certified dermatologist, and sister of fallen Chelsea MA Firefighter Peter Kannler, Christine Kannler, who has screened thousands of firefighters across New England. This program is saving lives and can now be utilized across the nation to bring skin cancer screenings to firehouses, where firefighters can spend a few moments from their busy day being screened for a melanoma and other skin cancers.

The goal of this document is to provide the fire service with a tool that can be replicated to assist in obtaining access to the AAD’s free Spot Skin Cancer program, specifically for firefighters that are known to be high risk for skin cancer.

What we know

Firefighters have a 21% greater risk of melanoma, the most serious form of skin cancer.  (Jalilian et al., 2019)

Firefighters have a 62% greater risk of melanoma between ages 30-49 compared to the general population of the same age (Pukkala et al., 2014)

The 9/11 World Trade Center  14-year follow-up study showed firefighters had more melanoma compared to the general population. (Li et al., 2021),  (Boffetta et al., 2021)

The top researchers from across the world have worked with the International Agency for Research on Cancer (IARC), their research has classified firefighting as a Group 1 carcinogen, meaning the firefighter has an elevated risk for cancer due to their occupation. They further listed melanoma as a cancer of concern for firefighters due to the higher rates in firefighters than in the general population. (Demers et al., 2022)

Firefighters are exposed to carcinogens (cancer-causing substances) in the line of duty, especially when fighting fires. Some of the carcinogens they may encounter include asbestos, benzene, formaldehyde, PAHs, and PFAS. These carcinogens can be inhaled, ingested, or absorbed through the skin (“Systemic Exposure to PAHs and Benzene in Firefighters Suppressing Controlled Structure Fires,” 2014) (Mazumder et al., 2023)

How the program works:

Fire Departments, unions or communities that want to receive a free screening will need to connect with a dermatologist in their area. The American Academy of Dermatologist has a member driven program to assist the Dermatologist with providing a free screenings to firefighters. If you have a dermatologist in mind they can access the AAD firefighter screening page below.
Firefighter Screening page
What will you need for a screening?

First you will need a dermatologist in your area willing to screen. To locate a dermatologist in your area the American Academy of dermatology has a Finder derm website where you can enter some basic information and find a derm in your area you can access this service below.
Find a Dermatologist
Department-wide screenings are welcome and will require some logistics to be successful.  Keep in mind one dermatologist can scream approximately 70 people per day. It is possible to get multiple dermatologists to screen but you'll need to work that out with the dermatologist that you connect with.

The typical screening setup uses bunk rooms, or private office spaces that allow for the privacy of the members being screened. When the FCSN conducts large screenings, we use pop up tents as exam rooms, but you could use any type of dividers that provide privacy.  Lighting is important as dermatologists need good light to do a screening.

There are several ways to hold screenings. Some departments require all on duty members to rotate into a central location to be screened, others send out a notice with the available dates for screening and allow members to sign up for a time slot. Typically, time slots are provided every six to 10 minutes per dermatologist, but you should ask your dermatologist how many people they would like to screen per hour.

There may be some equipment and power needs for the screening too. The FCSN Screening events include the tents and small LED lights that dermatologist can use. Some dermatologist have portable lights they will bring along. It is best to have the dermatologist access the tool kit to understand the needs.
Access the Toolkit
When should you schedule screenings?

The FCSN has found that it's easiest to schedule screenings on weekends or later in the week for dermatologists to be able to provide this service. This is a conversation you should have with the dermatologist that you make a connection with but in general we have discovered the most successful screening days our weekends.

Typical skin check workflow:

Pre-exam : You will need to fill out the AAD skin check form with basic information.

Exam : The dermatologist will provide a head to toe exam of the skin. IOt is helpful if you provide information on anything that concerns you, such as wounds that don’t heal for longer than 3-4 weeks or recur in the same spot, or skin changes that you notice.

Post-exam: At the end of the exam, the dermatologist will provide you with a copy of the exam notes and if any follow up is need will have a discussion on how to proceed.