Simple SummaryFirefighting has been identified as a high-risk occupation with increased risks for several types of cancers. Exposure to carcinogens in fire smoke and within the fire station, occupational factors such as shift work, and lifestyle are all plausible contributors to disease development. Prevention strategies and a change to fire service culture are crucial for primary cancer prevention among career firefighters.AbstractCareer firefighters are at considerable risk for chronic diseases, including an increased risk of various cancers, compared to the general population. Over the last two decades, several systematic reviews and large cohort studies have demonstrated that firefighters have statistically significant increases in overall and site-specific cancer incidence and site-specific cancer mortality compared to the general population. Exposure assessment and other studies have documented exposures to a variety of carcinogens in fire smoke and within the fire station. Other occupational factors such as shift work, sedentary behavior, and the fire service food culture may also contribute to this working population’s increased cancer risk. Furthermore, obesity and other lifestyle behaviors such as tobacco use, excessive alcohol consumption, poor diet, inadequate physical activity, and short sleep duration have also been associated with an increased risk of certain firefighting-associated cancers. Putative prevention strategies are proposed based on suspected occupational and lifestyle risk factors.