MGH teams up with Boston Fire for firefighter lung cancer study, volunteers needed

Massachusetts General Hospital is looking for volunteers to take part in a study to understand the risks of lung cancer among firefighters. Dr. Erica Warner, one of the study’s principal investigators, told Live Boston 617 the study stemmed from a partnership with the Boston Fire Department. BFD invited MGH to think about health and wellness programs for firefighters that could be paired with research opportunities.

That is what led to this study, which aims to understand whether the lung appearance and function and heart health of firefighters differ from people of similar age and background who are not firefighters. Researchers will also explore the relationship between occupational exposures and lung appearance and whether a blood test can help detect lung cancer.

Dr. Warner said many populations are either missed or not served well by lung cancer screenings standards. “Firefighters are one that immediately comes to mind,” she said. Lung cancer is detected using a low-dose CT scan. Studies have shown screening people at high risk with low-dose CT scans before symptoms appear can detect lung cancer early when the disease is easier to treat and more likely to be cured. Lung cancer screenings might also show if the patient has other conditions or diseases that need to be treated.

Dr. Warner said current lung cancer screening standards are based on smoking history and age. They don’t take into account any occupational risk factors. She learned some firefighters were paying for low-dose CT scans out of their own pockets because their medical insurance didn’t cover them. “Our hypothesis is some firefighters might meet high enough risk criteria to be eligible for lung screenings because of the duration of their employment and exposure to flames and air pollution,” she said. “We hope our study will provide some data that can give firefighters peace of mind and potentially expand their eligibility for lung cancer screenings.”

Dr. Warner said they’re still in the early stages of their Fire Health Study. Their goal is to enroll 420 firefighters. Firefighters from across the country are welcome to participate, but right now recruitment is focused on the greater Boston area. Current and retired firefighters between the ages of 40 and 65 are eligible. Firefighters younger than 40 are also eligible if they’ve been on the job for at least 10 years. All participants must be willing and able to receive a low-dose CT scan at MGH. Anyone who has received a low-dose CT scan within the past year can bypass this step by sharing their images with the study.

Dr. Warner said the study’s benefits are more long-term, but participants will either leave with peace of mind knowing their lungs are clear or if lung cancer is detected, an opportunity to earlier and more effective treatment.

“I think this study is really important to give access to potentially needed healthcare for firefighters in the future,” she said. According to the American Lung Association, lung cancer is the leading cause of cancer death in the United States. 139,603 people died from lung cancer in 2019, the U.S. Centers for Disease Control and Prevention reports.

The American Lung Association says on average, only 18% of lung cancer patients survive five years. More than half of people with lung cancer die within one year of being diagnosed. The high case-fatality rate is driven by the predominance of late stage diagnosis. Dr. Warner said while firefighters are at increased risk of lung cancer, little is known about how their lungs appear on low-does CT scan compared to similar non-firefighters. She added the risks of lung cancer among firefighters haven’t been specifically examined within the context of lung cancer screening trials.

Despite being generally fit and healthy as required by their job, a study published in 2016 by the National Institute for Occupational Safety and Health found firefighters face a 9% increase in cancer diagnoses and a 14% increase in cancer-related deaths when compared to the general population in the United States. At least 190 Boston firefighters have died from occupational cancer since 1990, according to Take No Smoke.

Boston Fire hosted the researchers at headquarters this past weekend for an informational clinic and skin cancer screening exams. Firefighters interested in the study can visit to take an eligibility survey and enroll if they wish to.