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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 \u201cold\u201d, studies starting between 1950 and 1970 as \u201cmedium\u201d, and later studies as \u201cnew\u201d.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The general cancer risk of firefighters was similar to the general population, but mSMR decreased over time (new studies: mSMR\u2009=\u20090.81, 95% CI 0.70\u20130.92). 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.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s00420-020-01539-0","type":"journal-article","created":{"date-parts":[[2020,4,18]],"date-time":"2020-04-18T12:02:41Z","timestamp":1587211361000},"page":"839-852","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":64,"title":["Cancer risks of firefighters: a systematic review and meta-analysis of secular trends and region-specific differences"],"prefix":"10.1007","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0148-8859","authenticated-orcid":false,"given":"Swaantje","family":"Casjens","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9560-5464","authenticated-orcid":false,"given":"Thomas","family":"Br\u00fcning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5340-5584","authenticated-orcid":false,"given":"Dirk","family":"Taeger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,4,18]]},"reference":[{"issue":"3","key":"1539_CR1","doi-asserted-by":"crossref","first-page":"e0120305","DOI":"10.1371\/journal.pone.0120305","volume":"10","author":"Y-S Ahn","year":"2015","unstructured":"Ahn Y-S, Jeong KS (2015) Mortality due to malignant and non-malignant diseases in Korean professional emergency responders. 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