Background: Florida Firefighters experience a higher risk of thyroid cancer than non-firefighters. This study examines
whether the histologic types and tumor stage of thyroid cancer is different among firefighters compared to other
Methods: Eligible cases were firefighters (n = 120) identified in a linkage of Florida Cancer Data System (FCDS)
registry records (1981–2014) and Florida State Fire Marshal’s Office employment and certification records, and nonfirefighters
classified into: blue-collar (n = 655), service (n = 834), white-collar (n = 4,893), and other (n = 1,789). Differences
in thyroid histologic type (papillary, follicular, and rare/other less common forms of thyroid cancer), tumor stage,
and age at diagnosis were evaluated using multinomial logistic regression models comparing blue-collar, service,
white-collar, and other occupational groups with firefighters. Univariate odds ratios as well as odds ratios adjusted for
age, gender, race, tumor stage, and year of diagnosis (aOR) and 95% confidence intervals (95%CI) were reported.
Results: Service (aOR = 4.12; 95%CI: 1.25—13.65), white-collar (aOR = 3.51; 95%CI: 1.08—11.36), and blue-collar
(aOR = 4.59; 95%CI: 1.40—15.07) workers had significantly higher odds of being diagnosed with rare histologic types
of thyroid cancer vs papillary type compared to firefighters. Service (aOR = 0.42; 95%CI: 0.27—0.66), white-collar
(aOR = 0.39; 95%CI: 0.26—0.59), blue-collar (aOR = 0.36; 95%CI: 0.23—0.56), and other (aOR = 0.34; 95%CI: 0.22—0.53)
occupational groups have a significantly lower odds of being diagnosed with rare vs papillary type at a younger age
(30—49 years) vs 50—69 years compared to firefighters. However, stage at diagnosis was not significantly different
among occupational groups.
Conclusion: Firefighters diagnosed with thyroid cancer experience a higher odds of papillary compared to rare
histologic types of thyroid cancer relative to other workers; there is no evidence of an increased odds of late-stage
diagnosis in firefighters relative to other worker groups. Firefighters may benefit from routine screening and active
surveillance of suspected thyroid tumors especially given the excellent treatment outcomes available for those diagnosed
with early-stage papillary thyroid tumors.
� Copyright©2013. Inventi Journals Pvt.Ltd. All Right Reserved.