H. R. 931 
One Hundred Fifteenth Congress 
of the 
United States of America 
AT THE SECOND SESSION 
Begun and held at the City of Washington on Wednesday, 
the third day of January, two thousand and eighteen 
An Act 
To require the Secretary of Health and Human Services to develop a voluntary 
registry to collect data on cancer incidence among firefighters. 
Be it enacted by the Senate and House of Representatives of 
the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the Firefighter Cancer Registry 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 Secretary), acting through the 
Director of the Centers for Disease Control and Prevention and 
in coordination with other agencies as the Secretary determines 
appropriate, shall develop and maintain, directly or through a grant 
or cooperative agreement, a voluntary registry of firefighters 
(referred to in this section as the Firefighter Registry) to collect 
relevant health and occupational information of such firefighters 
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 coordination activi-
ties related to the nationwide monitoring of the incidence of 
cancer among firefighters. 
(2) To collect, consolidate, and maintain, consistent with 
subsection (g), epidemiological information and analyses related 
to cancer incidence and trends among firefighters 
(c) RELEVANT DATA.— 
(1) DATA COLLECTION.—In carrying out the voluntary data 
collection for purposes of inclusion under the Firefighter Reg-
istry, the Secretary may collect the following: 
(A) Information, as determined by the Secretary under 
subsection (d)(1), of volunteer, paid-on-call, and career fire-
fighters, independent of cancer status or diagnosis. 
(B) Individual risk factors and occupational history 
of firefighters. 
(C) Information, if available, related to— 
(i) basic demographic information, including— 
(I) the age of the firefighter involved during 
the relevant dates of occupation as a firefighter; 
and 
(II) the age of cancer diagnosis;
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(ii) the status of the firefighter as either volunteer, 
paid-on-call, or career firefighter; 
(iii) the total number of years of occupation 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 informa-
tion on such number and type is unavailable, an esti-
mate of such number and type based on the method 
developed under subsection (d)(1)(D); and 
(v) other medical information and health history, 
including additional risk factors, as appropriate, and 
other information relevant to a cancer incidence study 
of firefighters. 
(2) INFORMATION ON DIAGNOSES AND TREATMENT.—In car-
rying out paragraph (1), with respect to diagnoses and treat-
ment of firefighters with cancer, the Secretary shall, as appro-
priate, enable the Firefighter 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 information; 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 STRATEGY.— 
(1) REQUIRED STRATEGY.—The Secretary shall, in consulta-
tion with the relevant stakeholders identified in subsection 
(e), including epidemiologists and pathologists, develop a 
strategy to coordinate data collection activities, including within 
existing State registries, for inclusion in the Firefighter Reg-
istry established 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 provide electronic access 
to relevant health information described in subsection 
(c)(2). 
(D) Working in consultation with the experts described 
in subsection (e), a reliable and standardized method for 
estimating the number of fire incidents attended by a fire-
fighter as well as the type of fire incident so attended 
in the case such firefighter is unable to provide such 
information. 
(2) REPORT TO CONGRESS.—The Secretary shall submit the 
strategy described in paragraph (1) to the Committee on Energy
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and Commerce of the House of Representatives and the Com-
mittee on Health, Education, 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 MAINTENANCE 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 firefighting agencies, 
a strategy for inclusion of firefighters in the registry that are 
representative of the general population of firefighters, that 
outlines the following: 
(A) How new information about firefighters will be 
submitted to the Firefighter Registry for inclusion. 
(B) How information about firefighters will be main-
tained 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 information. 
(D) Further information, as deemed necessary 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 Committee 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 appropriate, 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 developing 
and maintaining cancer registries. 
(2) Epidemiologists with experience in studying cancer 
incidence. 
(3) Clinicians with experience in diagnosing and treating 
cancer incidence. 
(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 Sec-
retary shall ensure that information and analysis in the Firefighter 
Registry are available, as appropriate, 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 Firefighter Registry 
are made available in a manner that, at a minimum, protects 
personal privacy to the extent required by applicable Federal and 
State privacy law.
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(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. 
Speaker of the House of Representatives. 
Vice President of the United States and
President of the Senate.