Battalion Chief Matthew Alba, head of the San Francisco Fire Department’s Division of Health, Safety and Wellness, told the Fire Commission on Oct. 8 that the department is designing a pilot program to provide advanced cancer screening for active firefighters.

Alba said the city has allocated $500,000 toward a pilot aimed primarily at active firefighters age 40 and older with at least five years of service, and that a temporary waiver of the city’s behested‑payment ordinance approved by the Board of Supervisors on Sept. 18 will permit soliciting private donations to expand the effort. “No firefighter should have to wait for an emergency to reveal what could have been caught earlier,” Alba said.

Why it matters: Firefighters face elevated cancer risk from job‑related exposures; early detection can change treatment and outcomes. Alba framed the pilot as a move from crisis response toward prevention and asked the commission to endorse the pilot’s mission, eligibility and oversight metrics.

Key facts and design decisions
- Funding: the city has set aside $500,000 (budgeted to be received July 2026). Alba said private donations could supplement that funding under the behested‑payment waiver (Resolution 420425) the Board passed unanimously on Sept. 18, 2025.
- Eligibility: the draft eligibility rule discussed in the meeting targets active firefighters 40 and older with five or more years of service; Alba said a tiered rollout may allow some tests to be offered more broadly.
- Services contemplated: advanced imaging and diagnostic screening modalities (MRI, CT, ultrasound) and care navigation for abnormal findings. Alba specifically noted a tiered approach beginning with lower‑cost tests and expanding to higher‑cost imaging as indicated.
- Timeline: program design and vendor selection are underway; target launch date given was July 1, 2026, pending final budget and vendor commitments.
- Metrics: Alba proposed measuring number of eligible firefighters screened, cancers detected by stage, program cost per screening and per diagnosis, follow‑up outcomes, and participant satisfaction.

Program choices and constraints
Alba said the department and partner organizations are still finalizing which screening modalities to include, balancing clinical merit and cost. During public comment and follow‑up discussion the union and Foundation noted that some blood‑based multi‑cancer detection tests remain under development; Alba and union representatives said the pilot will prioritize proven modalities and a practical, tiered rollout. Alba and union representatives also flagged privacy concerns that can accompany department‑run physicals and said the program must protect member confidentiality.

Public comment and partner notes
Sena Riahi, treasurer for San Francisco Firefighters Local 798 and a representative of the Firefighters Cancer Prevention Foundation, highlighted AB 1181 (recently chaptered) and said the foundation and the union are coordinating on modalities and outreach. Riahi noted the foundation’s tracking of firefighter cancer deaths and urged rapid implementation.

Commission response and next steps
Commissioners voiced support for the pilot in principle and asked for clear reporting on costs, vendor selection and outcomes. Alba asked the commission to endorse the pilot’s mission and proposed oversight approach; the meeting record shows discussion and support but no formal commission vote or policy change recorded at the Oct. 8 meeting.

Ending
Alba said he hopes the pilot will move from a short‑term effort to a sustainable, longer‑term program that combines city and private funding and that the department will return with vendor details, cost estimates and interim metrics during implementation.