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Abstract：
OBJECTIVE: The objective of this study was to conduct a systematic review and meta-analysis to evaluate the cancer risks among firefighters in the time course and from different geographical areas.
METHODS: A PubMed search was performed to identify cohort studies about cancer risk and firefighting presented with standardized incidence ratios (SIRs) or standardized mortality ratios (SMRs). Using random-effect models, meta-relative risk estimates (mSIRs, mSMRs) and 95% confidence intervals (CI) were assessed. Cohort studies with employment starting before 1950 were classified as \"old\", studies starting between 1950 and 1970 as \"medium\", and later studies as \"new\".
RESULTS: The general cancer risk of firefighters was similar to the general population, but mSMR decreased over time (new studies: mSMR = 0.81, 95% CI 0.70-0.92). We observed an increase of mSIR for melanoma of the skin and prostate cancer as well as a decrease of mSIR for stomach cancer with later employment onset. For those cancer sites, we did not observe a secular trend of mSMRs. Regional differences between relative cancer risks were particularly observed for bladder cancer.
CONCLUSIONS: Among other things, innovative firefighting techniques and better personal protective equipment have provided a safer and healthier working environment for firefighters over time leading to a reduction of overall cancer incidence and mortality ratios. Increased general preventive medical checkups and possible additional screenings for firefighters might have led to more findings of malignant melanoma of the skin and prostate cancer in the recent past.
METHODS: A PubMed search was performed to identify cohort studies about cancer risk and firefighting presented with standardized incidence ratios (SIRs) or standardized mortality ratios (SMRs). Using random-effect models, meta-relative risk estimates (mSIRs, mSMRs) and 95% confidence intervals (CI) were assessed. Cohort studies with employment starting before 1950 were classified as \"old\", studies starting between 1950 and 1970 as \"medium\", and later studies as \"new\".
RESULTS: The general cancer risk of firefighters was similar to the general population, but mSMR decreased over time (new studies: mSMR = 0.81, 95% CI 0.70-0.92). We observed an increase of mSIR for melanoma of the skin and prostate cancer as well as a decrease of mSIR for stomach cancer with later employment onset. For those cancer sites, we did not observe a secular trend of mSMRs. Regional differences between relative cancer risks were particularly observed for bladder cancer.
CONCLUSIONS: Among other things, innovative firefighting techniques and better personal protective equipment have provided a safer and healthier working environment for firefighters over time leading to a reduction of overall cancer incidence and mortality ratios. Increased general preventive medical checkups and possible additional screenings for firefighters might have led to more findings of malignant melanoma of the skin and prostate cancer in the recent past.
摘要：
目的：本研究的目的是进行系统评价和荟萃分析，以评估消防员在时间过程中和来自不同地理区域的癌症风险。
方法：进行了PubMed搜索，以确定具有标准化发病率（SIR）或标准化死亡率（SMR）的关于癌症风险和消防的队列研究。使用随机效应模型，元相对风险估计(MSIR，评估mSMR)和95%置信区间(CI)。1950年之前开始就业的队列研究被归类为“旧”，从1950年到1970年之间开始的“中等”研究，后来研究为“新”。
结果：消防员患癌症的风险与普通人群相似，但随着时间的推移，mSMR下降（新研究：mSMR=0.81，95%CI0.70-0.92）。我们观察到皮肤黑色素瘤和前列腺癌的mSIR增加，以及随着以后的就业发作，胃癌的mSIR降低。对于那些癌症部位，我们没有观察到mSMR的长期趋势。对于膀胱癌，尤其观察到相对癌症风险之间的区域差异。
结论：除其他外，随着时间的推移，创新的消防技术和更好的个人防护设备为消防员提供了更安全、更健康的工作环境，从而降低了整体癌症发病率和死亡率。在最近的过去，增加的一般预防性体检和可能的消防员额外筛查可能导致更多的皮肤恶性黑色素瘤和前列腺癌的发现。
方法：进行了PubMed搜索，以确定具有标准化发病率（SIR）或标准化死亡率（SMR）的关于癌症风险和消防的队列研究。使用随机效应模型，元相对风险估计(MSIR，评估mSMR)和95%置信区间(CI)。1950年之前开始就业的队列研究被归类为“旧”，从1950年到1970年之间开始的“中等”研究，后来研究为“新”。
结果：消防员患癌症的风险与普通人群相似，但随着时间的推移，mSMR下降（新研究：mSMR=0.81，95%CI0.70-0.92）。我们观察到皮肤黑色素瘤和前列腺癌的mSIR增加，以及随着以后的就业发作，胃癌的mSIR降低。对于那些癌症部位，我们没有观察到mSMR的长期趋势。对于膀胱癌，尤其观察到相对癌症风险之间的区域差异。
结论：除其他外，随着时间的推移，创新的消防技术和更好的个人防护设备为消防员提供了更安全、更健康的工作环境，从而降低了整体癌症发病率和死亡率。在最近的过去，增加的一般预防性体检和可能的消防员额外筛查可能导致更多的皮肤恶性黑色素瘤和前列腺癌的发现。
