PT  - JOURNAL ARTICLE
AU  - Mayris P Webber
AU  - Ankura Singh
AU  - Rachel Zeig-Owens
AU  - Joke Salako
AU  - Molly Skerker
AU  - Charles B Hall
AU  - David G Goldfarb
AU  - Nadia Jaber
AU  - Robert D Daniels
AU  - David J Prezant
TI  - Cancer incidence in World Trade Center-exposed and non-exposed male firefighters, as compared with the US adult male population: 2001–2016
AID  - 10.1136/oemed-2021-107570
DP  - 2021 Oct 01
TA  - Occupational and Environmental Medicine
PG  - 707--714
VI  - 78
IP  - 10
4099  - http://oem.bmj.com/content/78/10/707.short
4100  - http://oem.bmj.com/content/78/10/707.full
SO  - Occup Environ Med2021 Oct 01; 78
AB  - Objective To compare cancer incidence in Fire Department of the City of New York (FDNY) firefighters who worked at the World Trade Center (WTC) site to incidence in a population of non-WTC-exposed firefighters, the Career Firefighter Health Study (CFHS) cohort, and to compare rates from each firefighter cohort to rates in demographically similar US males.Methods FDNY (N=10 786) and CFHS (N=8813) cohorts included male firefighters who were active on 11 September 2001 (9/11) and were followed until death or 31 December 2016. Cases were identified from 15 state cancer registries. Poisson regression models assessed cancers in each group (FDNY and CFHS) versus US males, and associations between group and cancer rates; these models estimated standardised incidence ratios (SIRs) and adjusted relative rates (RRs), respectively. Secondary analyses assessed surveillance bias and smoking history.Results We identified 915 cancer cases in 841 FDNY firefighters and 1002 cases in 909 CFHS firefighters. FDNY had: higher rates for all cancers (RR=1.13; 95% CI 1.02 to 1.25), prostate (RR=1.39; 95% CI 1.19 to 1.63) and thyroid cancer (RR=2.53; 95% CI 1.37 to 4.70); younger median ages at diagnosis (55.6 vs 59.4; p<0.001, all cancers); and more cases with localised disease when compared with CFHS. Compared with US males, both firefighter cohorts had elevated SIRs for prostate cancer and melanoma. Control for surveillance bias in FDNY reduced most differences.Conclusions Excess cancers occurred in WTC-exposed firefighters relative to each comparison group, which may partially be explained by heightened surveillance. Two decades post-9/11, clearer understanding of WTC-related risk requires extended follow-up and modelling studies (laboratory or animal based) to identify workplace exposures in all firefighters.Reasonable requests for deidentified data will be considered by the investigators and the National Institute for Occupational Safety and Health.