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Fire departments embrace blood test to aid in early cancer detection

A lack of routine screening for many of the cancers firefighters are at risk of developing has led many departments to embrace modern approaches to improve early detection

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Firefighters remain the only occupation that the U.S. National Institute of Occupational Safety & Health (NIOSH) deems to have proven higher risk of cancer incidence and death over the population at large.

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Too many fire departments around the country share the tragedy of having members diagnosed with late-stage cancer, many at a young age. Firefighters remain the only occupation that the U.S. National Institute of Occupational Safety & Health (NIOSH) deems to have proven higher risk of cancer incidence and death over the population at large[1]. The largest study completed by NIOSH and the Center for Disease Control and Prevention (CDC) in 2016 included 30,000 U.S. firefighters. This study presented strong findings that firefighters, including the younger demographic, have a heightened risk of cancer, particularly cancers of the stomach, lungs and urinary system. As a result, the firefighter community has a greater number of cancer diagnoses and cancer-related deaths than the general U.S. population[2].

The importance of early detection in the battle against cancer is shown by the variance in five-year survival rates for individuals with lung cancer detected at different stages. The five-year survival rate for individuals diagnosed with Stage 1 lung cancer is 90%, but drastically falls to less than 1% for individuals diagnosed with Stage 4B[3],[4]. Screening may yield even greater benefits for higher-risk populations, including firefighters, than for the general population. Unfortunately, the only malignancies routinely screened for in men are prostate and colon cancers. This is drastically different from healthcare practices in the Far East, where routine, non-invasive screenings (blood tests and imaging) for multiple cancers is nearly universal.

The lack of routine screening approaches for many of the cancers for which firefighters are proven to have higher death rates has led many departments to embrace newer, more innovative approaches to improve early detection. For example, many fire departments have ordered OneTest for Cancer from 20/20 GeneSystems, Inc. These include departments in Grand Prairie, Texas; Clayton County, Ga.; and California Pines, Calif., as well as thousands of additional individual firefighters. OneTest is a multi-cancer screening tool that determines an individual’s cancer likelihood via a standard blood draw. OneTest reads the levels of protein biomarkers that are associated with several common tumor types, including those of the lung, liver, pancreas and intestines. In addition to reporting on biomarker levels, OneTest compares the tested individual’s biomarker patterns with a database of over 200,000 individuals previously screened with those same tumor markers and for whom cancer outcomes are known. This machine-learning approach has been shown to boost accuracy over standard tumor marker tests[5],[6],[7].

An abstract describing 20/20’s latest machine-learning advancements was awarded first place at the 2021 annual meeting of the American Association for Clinical Chemistry, the nation’s leading scientific organization for laboratory medicine.

Fire departments have used OneTest in one of two ways:

  1. Hosting an event for their firefighters to complete blood draws with the help of an on-site EMT, nurse or phlebotomist. Samples are then shipped to the lab in Rockville, Md., using the specially-provided cooler and shipping label. Depending on the size and requirements for the event, 20/20 team members are able to attend and support the process.
  2. Providing individual sample collection kits for their firefighters to complete the blood draw with their own physician and ship back to the lab.

20/20 is proud of the efforts to support firefighter health and are committed to sharing our message with the fire community around the nation. Chief Landry Merkison of the Clayton County (Ga.) Fire Department said, “As Chief, this was the easiest decision ever. We just bought [OneTest cancer screening kits] for our department. All 411 members have the option to participate if they would like. If your people are your greatest asset, why would you not protect them?”

For more information on OneTest for your department, please visit OneTestforCancer.com/firefighters.


  1. https://www.cdc.gov/niosh/pgms/worknotify/pdfs/ff-cancer-factsheet-final-508.pdf
  2. https://www.firefighterclosecalls.com/wp-content/uploads/2017/06/FF-Cancer-Fact-Sheet.pdf
  3. https://www.nejm.org/doi/full/10.1056/NEJMoa060476
  4. https://www.cancer.org/cancer/lung-cancer/detection-diagnosis-staging/staging-nsclc.html
  5. Cohen JD el al., “Combined circulating tumor DNA and protein biomarker-based liquid biopsy for the earlier detection of pancreatic cancers, PNAS (2017). pnas.org/cgi/doi/10.1073/pnas.1704961114
  6. Molina R, Marrades R, Auge J, et al. Assessment of a Combined Panel of six Serum Tumor Markers for Lung Cancer. Am J Respir Crit Care Med (2015) October. Doi: 10.1164/rccm.201404-0603oc.
  7. Montagnana M,Benati M, Danese E. Circulating biomarkers in epithelial ovarian cancer diagnosis: from present to future perspective. Ann Transl Med. 2017 Jul;5(13):276. doi: 10.21037/atm.2017.05.13.

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