The Cost of Waiting: How Cancer Is Reshaping Firefighting in Canada — and Why Early Detection Could Change Everything
By Len Garis and Todd Schierling
Firefighters spend their careers protecting the public from danger. But increasingly, the greatest danger they face is not the fire itself — it is what comes after. Across Canada, cancer has become the leading cause of line-of-duty death for firefighters, and the consequences ripple far beyond the individual diagnosis. Families are disrupted, departments are strained, and compensation systems are absorbing a growing burden that is both human and financial.
This is not a story about numbers alone. It is a story about preventable loss — and the opportunity to change the trajectory through earlier detection and coordinated screening.
We may have the data that points to the burden, but there isalso an opportunity to change the outcomes through a proactive, national screening strategy.
A Clear Picture of a Growing Burden
Analysis of of WorkSafeBC data provides a good example of the cancer burden facing firefighters. Between 2020 and 2025, more than 300 cancer claims were accepted for career and, volunteer firefighters. The majority came from career firefighters, but volunteers and paid-on-call members were far from exempt — a reminder that cancer risk follows exposure, not employment status.
The demographic pattern reflects the makeup of the fire service: most claims involved male firefighters. But what stands out most is the severity of the cancers being diagnosed. Many were advanced, aggressive, or fatal. Several cancer types — including pancreatic, brain, lung, and multiple myeloma — showed high fatality rates, reflecting how late these cancers are often detected.
These are cancers where early detection can make the difference between a treatable illness and a life-ending diagnosis.
In a recent 2025 survey of Health/Cancer Screening Programs in the 55 Career Professional Fire Departments in British Columbia, fewer than half have secured specific, dedicated cancer screening programs. A significant portion relies on general medical that may not address occupational risks, while an alarming number have no formal program in place, leaving members vulnerable.
41% have no program at all
33% have a specific Cancer Screening Program
15% have a general Wellness Program only
11% are developing a program
A combination of the Fire Department’s Screening Programs was either Employer-funded, co-funded Employer/Employee, or Employee-funded.
The Problem: A Patchwork System Creates Inequality
The problem emerging with the current system is clear: Screening programs depend on negotiating influence individual union locals, a fire fighter's access to life-saving early detection is often determined by their location . The patchwork of this approach has created inequalities. The negative consequences include:
Negotiations: Health screenings end up being traded off for other benefits or increases during local negotiations, treating a fundamental safety right as a benefit.
Inequity for Paid-on-Call / Volunteers: Small and rural municipalities often lack the funds for advanced screenings, leaving volunteer fire fighters—who face the same toxins—with less protection.
The Financial Reality: A System Under Strain
Workers’ compensation systems exist to support injured workers, and they do so with integrity. But the financial burden of firefighter cancers is significant — and rising.
WorkSafeBC’s own data shows that the total cost of allowed firefighter cancer claims over the five-year period exceeded $37 million for male firefighters alone, with additional costs for female and unknown-gender claimants. These costs include healthcare, wage-loss benefits, rehabilitation, and survivor benefits.
The dataset also shows:
Healthcare costs exceeded $8.2 million
Long-term disability and wage-loss benefits added more than $3.5 million
Survivor benefits — reflecting fatal cancers — totalled nearly $22 million
These are not abstract figures. They represent real families, real losses, and real financial pressures on a system designed to protect workers.
And even these numbers tell only part of the story. They do not capture:
The overtime and backfill required when a firefighter is off work
The cost of recruiting and training replacements
The operational strain on departments already facing staffing pressures
The long-term pension impacts of early mortality
The financial disruption experienced by families
When these broader impacts are considered, the true cost of firefighter cancer is far greater than what appears in compensation data.
The Human Impact: Families Carry the Weight
Behind every claim is a family navigating fear, uncertainty, and disruption.
When a firefighter is diagnosed with cancer, the impact is immediate. Spouses often become caregivers overnight. Children lose stability. Household income drops. Travel for treatment becomes routine. The emotional toll becomes constant.
Many of the fatal claims in the dataset involved firefighters in their 40s, 50s, and early 60s — people in the middle of their careers, with mortgages, dependent children, and spouses still working. These are not retirees. These are active members of their communities, often at the peak of their professional experience.
Survivor benefits help, but they cannot replace decades of lost income, pension contributions, or the long-term security families expected. The loss is permanent, and the disruption is profound.
The Employer Impact: Operational and Organizational Strain
Fire departments — career, composite, and volunteer — also feel the impact of cancer diagnoses.
When a firefighter is off work for treatment, departments must backfill shifts, often relying on overtime. Training pipelines are disrupted. Senior leadership capacity is reduced. In volunteer and paid-on-call departments, the loss of even one experienced member can have outsized effects on response capacity and community safety.
These operational pressures rarely appear in compensation data, but they are felt acutely by chiefs, municipal leaders, and crews who must absorb the workload.
Cancer does not just affect the individual firefighter — it affects the entire system around them.
Why Screening Matters: Prevention, Not Expense
The most important insight from the data is this: the cancers causing the highest burden are the ones where early detection makes the biggest difference.
Pancreatic, brain, lung, and multiple myeloma cancers — all of which appear frequently in firefighter claims — are often diagnosed late, when treatment options are limited and survival rates are low. But when these cancers are caught early, outcomes improve dramatically.
Early detection reduces:
Treatment intensity and duration
Time off work
Long-term disability
Survivor benefit payouts
Operational disruption
Family hardship
Early detection increases:
Survival rates
Treatment options
Return-to-work likelihood
Quality of life
Family stability
From an economic standpoint, screening is not a cost — it is a cost-avoidance strategy. It reduces the long-term financial burden on compensation systems, stabilizes municipal budgets, and preserves the workforce capacity departments rely on.
The Cost of Inaction
The WorkSafeBC data shows that late-stage cancers generate the highest costs — financially and emotionally. When cancers are detected only after symptoms appear, treatment is more complex, recovery is less likely, and the long-term burden on families and employers is far greater.
Canada has an opportunity to shift from a reactive model — diagnosing cancer after it has already advanced — to a proactive model that identifies cancer early, when it is most treatable.
This shift is not only a moral imperative. It is a practical one.
A National Opportunity: Building a Firefighter Screening Strategy
A coordinated national screening program could include:
Regular cancer screening for all firefighters
Mobile screening units for rural and volunteer departments
Integration with presumptive legislation
Federal–provincial cost-sharing
Partnerships with cancer agencies and research institutions
Data collection to track outcomes and refine protocols
This is not about creating new bureaucracy. It is about saving lives, reducing costs, and supporting families.
Firefighters face unique occupational exposures — from toxic smoke to diesel exhaust to contaminated gear — that justify a dedicated screening approach. Other countries have already moved in this direction. Canada has the opportunity to lead.
Conclusion: A Moral and Economic Imperative
The data tells a clear story.
Firefighters are developing cancers at rates that are costing families their loved ones, costing employers their most experienced members, and costing compensation systems tens of millions of dollars. These costs are real, but they are not inevitable.
Early detection and screening offer a path forward — one that protects firefighters, stabilizes families, and reduces the financial burden on employers and compensation systems.
Firefighters show up for Canada every day.
A national screening strategy is how Canada can finally support them in return.
This strategy would give employers a viable opportunity to establish a minimum standard of comprehensive health and cancer screening for all firefighting personnel.
Todd Schierling is the president of the BC Professional Firefighters Association, a captain with the Surrey Fire Services and an IAFF 6th District field service representative. Contact him at president@bcpffa.org.
Len Garis is Fire Chief (ret) for the city of Surrey, B.C., Research Associate – University of the Fraser Valley, and associate scientist emeritus with the B.C. Injury Research and Prevention Unit. Contact him at lwgaris@outlook.com.
