Lung Cancer Screening CT for Firefighters

University of California San Francisco (UCSF)

Status: Begins enrollment this month

Conditions: Lung Diseases, Interstitial; Exposure Occupational; Exposure to Pollution; Occupational Exposure; Lung Diseases; Exposure, Inhalation; Lung Cancer; Occupational Lung Disease; Smoke Inhalation; Interstitial Lung Disease

Treatments: Other: Questionnaires; Procedure: Low-dose Computerized tomography (CT) of Chest; Other: Medical History

Study type: Interventional

Funder types: Other

Identifiers

NCT06836414

NCI-2025-00336 (Registry Identifier)

24053

Details and patient eligibility

About

Firefighters are at increased risk for cancer due to exposure to carcinogenic substances. Current lung cancer screening guidelines are predominantly based on smoking history and do not take into account high risk occupational exposures such as firefighting. This study aims to provide chest computed tomography (CT) scans to firefighters to determine the prevalence of lung cancer, other cancers detectable on CT chest, and lung diseases associated with increased cancer risk.

Full description

This is a single-group prospective interventional study and a community-based participatory project led by University of California, San Francisco and in close collaboration with the firefighter community in California.

PRIMARY OBJECTIVE:

I. Determine the prevalence of lung cancer, other cancers and cancer risk factors detectable on chest Computerized Tomography (CT) (Aim 1).

II. Identify imaging and non-imaging predictors of lung cancer and other cancers detectable on chest CT.

SECONDARY OBJECTIVE:

I. Determine the prevalence of incidental findings on chest CT (Aim 1).

II. Determine the risk factors for cancer development in firefighters (Aim 2).

EXPLORATORY OBJECTIVES:

I. Long term follow-up to determine the incidence of lung cancer and other cancers among firefighters.

II. Develop a firefighter cancer imaging registry.

OUTLINE:

Participants will be administered a single, low dose chest CT to included participants and collect comprehensive demographic, clinical, and occupational data. Participants will be followed up at 1-2 months, for at least 1 year and up to 10 years to collect any follow-up imaging and biopsy results, if applicable.

Enrollment: 1,200 estimated patients

Sex: All

Ages: 35+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

1. Age 35 years or greater. If the participant is above the age of 80, participants must be otherwise healthy and well-fit to undergo treatment if lung cancer were to be discovered.
2. Never smoker or quit more than 15 years ago.
3. Able to understand study procedures and to comply with them for the entire length of the study.
4. Ability of individual or legal guardian/representative to understand a written informed consent document, and the willingness to sign it.
5. Length in profession for 10 or more years. This includes both volunteer firefighting and professional firefighting, self-attested as verifiable by professional records.

Additional cases for Aim 2:

1. Age 18+, may include deceased firefighters.
2. A previous or current history of confirmed thoracic malignancy (except localized skin cancer, cancer in situ, or other localized cancers)

Exclusion criteria

• Aim 1:

  1. Contraindication to any study-related procedure or assessment.
  2. Personal history of malignancy within 5 years (except localized skin cancer, cancer in situ, or localized cancers that are definitively treated and are unlikely to recur) or lung cancer at any time.
  3. Participants will be assessed for active pregnancy per standard procedure for clinical lung cancer screening CT at University of California, San Francisco which includes asking the participants directly along with documentation of whether the negative pregnancy was self-reported or confirmed with a urine pregnancy test.
  4. Prior CT chest within 1 year.
  5. Symptoms highly suggestive of lung cancer, including unexplained weight loss of over 30 pounds (lbs) within the past 12 months or unexplained hemoptysis.

• Aim 2:

No exclusion criteria

Trial design

Primary purpose: Prevention

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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1,200 participants in 2 patient groups

Firefighters (Lung Screening CT)

Other group

Description:

Participants will receive a single, low-dose, chest CT without contrast as indicated for lung cancer screening. Participants will be followed up for at least 1 year following the scan and have ongoing medical record reviews.

Treatment:

Other: Medical History

Procedure: Low-dose Computerized tomography (CT) of Chest

Other: Questionnaires

Firefighters with Previously Diagnosed Malignancy

Other group

Description:

Participants with a history of cancer will have a medical record review as part of a case-control cohort.

Treatment:

Other: Medical History

Sponsor of this trial

Lead Sponsor

University of California San Francisco (UCSF)

Collaborating Sponsor

Hayward Firefighters Local 1909 of the International Association of Firefighters