In the Senate of the United States, 
May 10, 2018. 
Resolved, That the bill from the House of Representa-
tives (H.R. 931) entitled ‘‘An Act to require the Secretary of 
Health and Human Services to develop a voluntary registry 
to collect data on cancer incidence among firefighters.’’, do 
pass with the following 
AMENDMENT: 
Strike all after the enacting clause and insert the 
following: 
SECTION 1. SHORT TITLE. 
This Act may be cited as the Firefighter Cancer Reg-
istry Act of 2018. 
SEC. 2. VOLUNTARY REGISTRY FOR FIREFIGHTER CANCER 
INCIDENCE. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (referred to in this section as the Sec-
retary), acting through the Director of the Centers for Dis-
ease Control and Prevention and in coordination with other
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agencies as the Secretary determines appropriate, shall de-
velop and maintain, directly or through a grant or coopera-
tive agreement, a voluntary registry of firefighters (referred 
to in this section as the Firefighter Registry) to collect rel-
evant health and occupational information of such fire-
fighters for purposes of determining cancer incidence. 
(b) USE OF FIREFIGHTER REGISTRY.—The Firefighter 
Registry may be used for the following purposes: 
(1) To improve data collection and data coordi-
nation activities related to the nationwide monitoring 
of the incidence of cancer among firefighters. 
(2) To collect, consolidate, and maintain, con-
sistent with subsection (g), epidemiological informa-
tion and analyses related to cancer incidence and 
trends among firefighters 
(c) RELEVANT DATA.— 
(1) DATA COLLECTION.—In carrying out the vol-
untary data collection for purposes of inclusion under 
the Firefighter Registry, the Secretary may collect the 
following: 
(A) Information, as determined by the Sec-
retary under subsection (d)(1), of volunteer, 
paid-on-call, and career firefighters, independent 
of cancer status or diagnosis.
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(B) Individual risk factors and occupa-
tional history of firefighters. 
(C) Information, if available, related to— 
(i) basic demographic information, in-
cluding— 
(I) the age of the firefighter in-
volved during the relevant dates of oc-
cupation as a firefighter; and 
(II) the age of cancer diagnosis; 
(ii) the status of the firefighter as ei-
ther volunteer, paid-on-call, or career fire-
fighter; 
(iii) the total number of years of occu-
pation as a firefighter and a detailing of 
additional employment experience, whether 
concurrent, before, or anytime thereafter; 
(iv)(I) the approximate number of fire 
incidents attended, including information 
related to the type of fire incidents and the 
role of the firefighter in responding to the 
incident; or 
(II) in the case of a firefighter for 
whom information on such number and 
type is unavailable, an estimate of such
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number and type based on the method devel-
oped under subsection (d)(1)(D); and 
(v) other medical information and 
health history, including additional risk 
factors, as appropriate, and other informa-
tion relevant to a cancer incidence study of 
firefighters. 
(2) INFORMATION
ON
DIAGNOSES
AND
TREAT-
MENT.—In carrying out paragraph (1), with respect 
to diagnoses and treatment of firefighters with cancer, 
the Secretary shall, as appropriate, enable the Fire-
fighter Registry to electronically connect to State- 
based cancer registries, for a purpose described by 
clause (vi) or (vii) of section 399B(c)(2)(D) of the 
Public Health Service Act (42 U.S.C. 280e(c)(2)(D)), 
to obtain— 
(A) date of diagnoses and source of informa-
tion; and 
(B) pathological data characterizing the 
cancer, including cancer site, state of disease 
(pursuant to Staging Guide), incidence, and 
type of treatment. 
(d) FIREFIGHTER REGISTRY COORDINATION STRAT-
EGY.—
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(1) REQUIRED STRATEGY.—The Secretary shall, 
in consultation with the relevant stakeholders identi-
fied in subsection (e), including epidemiologists and 
pathologists, develop a strategy to coordinate data col-
lection activities, including within existing State reg-
istries, for inclusion in the Firefighter Registry estab-
lished under this Act. The strategy may include the 
following: 
(A) Increasing awareness of the Firefighter 
Registry and encouraging participation among 
volunteer, paid-on-call, and career firefighters. 
(B) Consideration of unique data collection 
needs that may arise to generate a statistically 
reliable representation of minority, female, and 
volunteer firefighters, including methods, as 
needed, to encourage participation from such 
populations. 
(C) Information on how the Secretary will 
store data described in subsection (c)(1) and pro-
vide electronic access to relevant health informa-
tion described in subsection (c)(2). 
(D) Working in consultation with the ex-
perts described in subsection (e), a reliable and 
standardized method for estimating the number 
of fire incidents attended by a firefighter as well
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as the type of fire incident so attended in the 
case such firefighter is unable to provide such in-
formation. 
(2) REPORT TO CONGRESS.—The Secretary shall 
submit the strategy described in paragraph (1) to the 
Committee on Energy and Commerce of the House of 
Representatives and the Committee on Health, Edu-
cation, Labor, and Pensions of the Senate not later 
than 30 days after the date of the completion of the 
strategy. 
(3) GUIDANCE
FOR
INCLUSION
AND
MAINTE-
NANCE OF DATA ON FIREFIGHTERS.—The Secretary 
shall develop, in consultation with the stakeholders 
identified in subsection (e), State health agencies, 
State departments of homeland security, and volun-
teer, paid-on-call, combination, and career fire-
fighting agencies, a strategy for inclusion of fire-
fighters in the registry that are representative of the 
general population of firefighters, that outlines the fol-
lowing: 
(A) How new information about firefighters 
will be submitted to the Firefighter Registry for 
inclusion.
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(B) How information about firefighters will 
be maintained and updated in the Firefighter 
Registry over time. 
(C) A method for estimating the number of 
fire incidents attended by a firefighter as well as 
the type of fire incident so attended in the case 
such firefighter is unable to provide such infor-
mation. 
(D) Further information, as deemed nec-
essary by the Secretary. 
(e) CONSULTATION AND REPORT.—The Secretary shall 
consult with non-Federal experts on the Firefighter Registry 
established under this section, and shall submit to the Com-
mittee on Health, Education, Labor, and Pensions of the 
Senate and the Committee on Energy and Commerce of the 
House of Representatives a report that includes, as appro-
priate, information on goals achieved and improvements 
needed to strengthen the Firefighter Registry. Such non- 
Federal experts shall include the following: 
(1) Public health experts with experience in de-
veloping and maintaining cancer registries. 
(2) Epidemiologists with experience in studying 
cancer incidence. 
(3) Clinicians with experience in diagnosing and 
treating cancer incidence.
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(4) Active and retired volunteer, paid-on-call, 
and career firefighters as well as relevant national 
fire and emergency response organizations. 
(f) RESEARCH AVAILABILITY.—Subject to subsection 
(g), the Secretary shall ensure that information and anal-
ysis in the Firefighter Registry are available, as appro-
priate, to the public, including researchers, firefighters, and 
national fire service organizations. 
(g) PRIVACY.—In carrying out this Act, the Secretary 
shall ensure that information in and analysis of the Fire-
fighter Registry are made available in a manner that, at 
a minimum, protects personal privacy to the extent re-
quired by applicable Federal and State privacy law. 
(h) AUTHORIZATION OF FUNDS.—To carry out this 
section, there are authorized to be appropriated $2,500,000 
for each of the fiscal years 2018 through 2022. 
Attest: 
Secretary.