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By: Niki Tonks, Director of Marketing and Communications, Department of Surgery, University of Utah
Takeaways:
- Many of the toxins firefighters are exposed to are filtered through the kidneys.
- That’s why urologic evaluations are critical parts of comprehensive cancer screenings for firefighters.
Impact: Huntsman Cancer Institute is using research and early detection to provide lifesaving cancer screening for firefighters.
Firefighters routinely run toward danger, facing intense heat, smoke, and toxic exposures in the line of duty. A new statewide initiative, supported by Utah House Bill 65, is working to better understand and reduce the long-term health risks associated with this livelihood and lifesaving service through comprehensive cancer screening.
At Huntsman Cancer Institute at the University of Utah, this effort brings together specialists across disciplines, including internal medicine, dermatology, and urology, to provide targeted screenings for firefighters. While the broader program highlights the importance of early detection, the role of urology offers a critical, and often less visible, piece of the story.
Why Urology Matters in Firefighter Health
Many of the toxins firefighters are exposed to through inhalation or skin contact are ultimately processed by the body.
“These exposures don’t just disappear,” says R. Drew Durtschi, MD, who performs the urologic component of the screening program alongside John P. Smith, DO. “They’re filtered through the kidneys and concentrated in the urinary tract, which is why we pay such close attention to urologic health in this population.”
These pollutants increase the risk of developing cancer in the urinary system, particularly the following:
It may also have effects on the following:
What Urologic Screening Looks Like
As part of the comprehensive screening clinic, firefighters meet with urology providers during a coordinated visit that includes multiple specialties. By the time they arrive, most patients have already completed advanced imaging and lab work, allowing for a detailed, same-day review by all specialists.
The urologic evaluation includes the following:
- A symptom assessment to evaluate urinary function
- PSA blood test, often used as an initial screen for prostate cancer
- Urinalysis to detect microscopic blood, an early indicator of bladder or kidney cancer
- Full-body MRI, which provides detailed images of the kidneys, bladder, and prostate
- A physical exam, including prostate evaluation when appropriate
While full-body MRI is not standard for the general population, it is being used in this program to explore whether enhanced screening may improve early detection in high-risk groups like firefighters.
A Unique and Engaged Patient Population
For Durtschi, one of the most meaningful aspects of the program has been working directly with firefighters themselves.
“It’s been a really fun population to work with,” he says. “Many of them have a strong base of medical knowledge, so the conversations are different—they’re engaged, they ask thoughtful questions, and they really want to understand what we’re looking for and why.”
That engagement creates a more collaborative clinical experience, where discussions go beyond routine screening and into deeper conversations about risk, prevention, and long-term health.
At the same time, those conversations are often grounded in the realities of the job. Firefighters frequently share stories from the field—some inspiring, others sobering—that underscore the very real risks they face.
“It’s rewarding, but it can also be humbling,” Durtschi says. “You hear what they’ve been through, and it reinforces why this work matters.”
Reaching Patients Who Might Otherwise Go Unscreened
One of the most significant impacts of the program is its ability to reach individuals who may not regularly seek medical care.
“A number of the firefighters haven’t been to a doctor in years for some, this is their first comprehensive screening. This creates a real opportunity, not just to detect disease, but to educate and intervene early.”
Early Findings and Real Impact
Though still in its early stages, the program has already identified patients with concerning symptoms and findings requiring follow-up care. In similar programs, early detection has proven lifesaving.
In one case from a comparable initiative, a firefighter underwent screening with no symptoms and was found to have prostate cancer, caught early enough to allow for effective treatment. Stories like this highlight the potential impact of proactive, specialty-driven screening.
A Foundation for Future Research
Beyond individual patient care, the program is also generating valuable data to better understand how occupational exposures influence cancer risk.
For urology, these are some key questions:
- Do firefighters require different screening protocols than the general population?
- Can routine use imaging, like MRI, improve early detection of urologic cancers?
- How do exposure patterns correlate with cancer development over time?
As data is collected over the three-year program, urology researchers will play an important role in analyzing outcomes and shaping future recommendations.
A Collaborative Effort with Lasting Impact
The firefighter screening program reflects a broader shift toward personalized, risk-based screening, where occupation and exposure history inform how care is delivered.
“Firefighters dedicate their careers to protecting others, this program is one way we can help protect them by identifying risks early and giving them the tools and knowledge to take care of their health.”