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This study aims to systematically review the literature on the association of firefighting occupation and cancer incidence and mortality, overall and for specific cancer sites. A systematic review using PubMed, Embase, and Web of Science was performed up to January 1, 2018. We extracted risk estimates of cancers and calculated summary incidence risk estimates (SIRE), summary mortality risk estimates (SMRE), and their 95% confidence intervals (CI). Publication bias and risk of bias in individual studies were assessed using Begg's and Egger's tests and the Newcastle\u2010Ottawa scale (NOS), respectively. We included 50 papers in the review and 48 in the meta\u2010analysis. We found significantly elevated SIREs for cancer of the colon (1.14; CI 1.06 to 1.21), rectum (1.09; CI 1.00 to 1.20), prostate (1.15; CI 1.05 to 1.27), testis (1.34; CI 1.08 to 1.68), bladder (1.12; CI 1.04 to 1.21), thyroid (1.22; CI 1.01 to 1.48), pleura (1.60; CI 1.09 to 2.34), and for malignant melanoma (1.21; CI 1.02 to 1.45). We found significant SMREs of 1.36 (1.18 to 1.57) and 1.42 (1.05 to 1.90) for rectal cancer and Non\u2010Hodgkin's lymphoma, respectively. Considering the significantly elevated risk of some cancers in this occupational group, we suggest improving preventive measures and securing adequate and relevant medical attention for this group. Further studies with more accurate and in\u2010depth exposure assessments are indicated.<\/jats:p>","DOI":"10.1002\/ijc.32199","type":"journal-article","created":{"date-parts":[[2019,2,9]],"date-time":"2019-02-09T07:49:37Z","timestamp":1549698577000},"page":"2639-2646","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":150,"title":["Cancer incidence and mortality among firefighters"],"prefix":"10.1002","volume":"145","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5423-9442","authenticated-orcid":false,"given":"Hamed","family":"Jalilian","sequence":"first","affiliation":[{"name":"Department of Occupational Health and Safety, Faculty of Health Hormozgan University of Medical Sciences  Bandar Abbas Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mansour","family":"Ziaei","sequence":"additional","affiliation":[{"name":"School of Health and Nutrition Bushehr University of Medical Sciences  Bushehr Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabete","family":"Weiderpass","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Faculty of Health Sciences University of Troms\u00f8, The Arctic University of Norway  Troms\u00f8 Norway"},{"name":"Department of Research Cancer Registry of Norway \u2010 Institute of Population\u2010Based Cancer Research  Oslo Norway"},{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"},{"name":"Genetic Epidemiology Group, Folkh\u00e4lsan Research Center, and Faculty of Medicine Helsinki University  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3720-4659","authenticated-orcid":false,"given":"Corina Silvia","family":"Rueegg","sequence":"additional","affiliation":[{"name":"Oslo Centre for Biostatistics and Epidemiology Oslo University Hospital and Institute of Basic Medical Sciences, University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6431-308X","authenticated-orcid":false,"given":"Yahya","family":"Khosravi","sequence":"additional","affiliation":[{"name":"Department of Occupational Health and Safety, Research Center for Health, Safety and Environment Alborz University of Medical Sciences  Karaj Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Kjaerheim","sequence":"additional","affiliation":[{"name":"Department of Research Cancer Registry of Norway \u2010 Institute of Population\u2010Based Cancer Research  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,3]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10694-011-0212-2"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/15298660008984572"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/15459624.2014.890286"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/15459624.2015.1091964"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhazmat.2016.03.012"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/annhyg\/meu036"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1039\/c0em00591f"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/15459624.2016.1183016"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/15459624.2016.1165823"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chemosphere.2012.12.070"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00420-015-1074-6"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2015.11.014"},{"key":"e_1_2_7_14_1","first-page":"227","article-title":"Mortality in city firemen. 2. 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