Cancer Screening Eligibility and Uptake in a New Jersey Volunteer Fire Department

Authors: Shah NN, Black TM, Steinberg MB, Black K, Graber JM

Category: Early Detection & Risk Prediction
Conference Year: 2020

Abstract Body:
Purpose of Study: Firefighters have higher cancer risk compared to the general population, yet cancer screening behavior among firefighters has been rarely studied, especially among volunteer firefighters. This study explores the uptake and predictors of colon, lung, and prostate cancer screenings in a New Jersey (NJ) volunteer fire department. Methods: A survey was administered to members of the volunteer Toms River Fire Department (TRFD) capturing demographics, healthcare access and use, family cancer history, fire service experience, and environmental and behavioral risk factors. Uptake and predictors of colon, lung and prostate cancer screening, according to the United States Preventative Service Task Force (USPSTF) recommendations, were assessed. Predictors were assessed using bivariate analysis (Chi-square, Fisher’s Exact and T-tests). TRFD colon cancer screening rate was compared to colorectal cancer screening uptake as assessed by the NJ Behavioral Risk Factor Survey (NJBRFSS), 2012-2017. Results: Of the 120 participants, 90% (95%CI: 84.6, 95.4) were male and non-Hispanic white. We included 110 respondents for colon, 106 for prostate and 95 for lung cancer screening; 46.4% (95%CI: 36.9, 55.8), 31.1% (95%CI: 22.2, 40.1), and 0% were eligible to receive cancer screening, respectively. Colon and prostate cancer screening uptake rates were similar for participants [76.5% (95%CI: 64.4, 88.5), and 78.8% (95%CI: 64.1, 93.5) respectively]. TRFD had higher colon cancer screening uptake compared to the NJBRFSS age-adjusted rate for employed white males (66.7%; 95%CI: 64.7, 68.7). Some participants were screened outside of the USPSTF criteria: 3.2% (95%CI: 0.1, 6.7) received a chest CT for lung cancer screening, and screenings outside of the age criteria included 15.3% (95% CI: 5.8, 24.7) for colon cancer and 23.3% (95%CI: 13.4, 33.2) for prostate cancer (PSA test). Age was significantly associated with colon and prostate cancer screenings (p=0.002, 0.01 respectively). Conclusions: Understanding cancer screening behavior can help reduce cancer mortality in firefighters who are at increased risk for some cancers. Recently, some firefighter groups have made efforts to expand cancer screening criteria given concerns about excess cancer risk.

Keywords: Cancer Screening, Screening Uptake, Firefighters