[16] Recent studies suggest that exposure on the fireground may increase risk to firefighters of certain types of cancer and other chronic diseases.

Limited evidence of increasing risk among firefighters was also found for five other cancers: colon, prostate, testicular, melanoma of the skin, and non-Hodgkin lymphoma.

It is also important to collect information on personal and lifestyle risk factors (e.g. tobacco and alcohol use, sleep deprivation, diet, and physical activity) in the U.S. fire service to better understand how they may affect the relationship between firefighting and cancer.

[38][39][40] Due to the lack of central and comprehensive sources of data, research on cancer rates amongst firefighters has been challenging.

Although some evidence suggests the risk for specific cancer types could vary for male, female, and non-white firefighters,[41][42][43][44] the strength of the evidence related to cancer in demographic subgroups is limited because many previous studies have mainly comprised white male samples of firefighters.

Larger samples of female firefighters and minority groups are needed before the conclusions can be drawn about cancer risk across the nation’s diverse fire service.

[48][49] It required the Centers for Disease Control and Prevention to create a registry designed to collect data on cancer rates among U.S.

[59] NIOSH, part of the CDC, has been given authority to lead this effort, beginning in fiscal year 2019, with input from the scientific and firefighting communities.

The proposed approach for the NFR states it will be a voluntary workplace health surveillance system of U.S. firefighters over the age of 18 years.

"[60][61] According to the Republican Policy Committee's summary, the NFR aims to provide decision makers with data to help them create new protocols to protect firefighters.

[60][62] Following enrollment, NIOSH will send NFR participants notifications for periodic voluntary follow-up questionnaires (e.g., one per year) to be filled out through the web portal.

Department incident records will provide NIOSH investigators with apparatus and incident-specific information to be used as surrogates of exposure for exposure-response analyses.