Maryland honors its firefighters with free cancer screenings under a new law

New law honors a firefighter lost to cancer

Maryland career firefighters now get free preventive cancer screenings under a law that took effect Jan. 1, 2026.

The James “Jimmy” Malone Act bars counties with self-insured health plans from charging copays, coinsurance, or deductibles for these screenings.

The law covers 10 types of cancer, including bladder, breast, colorectal, lung, prostate, and skin. It passed the Maryland House 140-0 and the Senate 47-0.

Gov. Wes Moore signed it on May 20, 2025.

Jimmy Malone served Maryland for decades

The law carries the name of James E. “Jimmy” Malone Jr., a former state delegate and career firefighter. Malone represented Baltimore and Howard counties in the House of Delegates from 1995 to 2014.

He spent his career with Baltimore County Fire, retiring as a lieutenant in 2007. He joined the Arbutus Volunteer Fire Department at 18 and became its youngest-ever president.

Malone died of brain cancer on Dec. 16, 2024, at age 67.

Malone fought for firefighter safety in the office

Malone didn’t just fight fires. During his time in the legislature, he pushed for laws targeting cancer-causing PFAS chemicals in firefighter protective gear.

That work laid the groundwork for the screening law that now carries his name. His campaign slogan summed up his approach: “You’re never alone with Jimmy Malone.”

The connection between PFAS exposure and cancer among firefighters has only grown clearer in recent years.

Counties can choose how to provide screenings

Counties have options for meeting the law’s requirements.

They can offer a no-cost annual exam that follows the International Association of Firefighters guidelines.

Or they can apply for a grant to pay for newer screening tools, including multi-cancer early detection blood tests. These blood tests are an emerging tool in cancer prevention.

The key distinction here is that this law focuses on catching cancer early through preventive screenings, not on paying benefits after a diagnosis.

State will track the results through 2028

The law builds in accountability. Counties must collect data on every cancer screening they provide in 2026 and 2027 and report it to the Maryland Health Care Commission.

The commission will then study those results and deliver a report by Dec. 1, 2028. That report could help Maryland decide whether to expand the program down the road.

The data collection piece makes this law more than a mandate; it’s also a research tool.

Volunteer firefighters fall outside the law

Here’s a notable gap: the Malone Act only covers career firefighters, meaning paid, full-time employees of Maryland counties. Volunteer firefighters don’t qualify.

That matters because volunteers make up a large share of the fire service in Maryland and across the country.

Some counties, like Howard County, already offer cancer screenings to their operational volunteers on their own. But no Maryland law extends the same screening requirements to volunteer departments statewide.

Toxic exposures put firefighters at higher risk

Firefighters face cancer-causing chemicals nearly every time they respond to a fire. Those exposures include polycyclic aromatic hydrocarbons, benzene, asbestos, and PFAS chemicals.

Night shifts, which firefighters can’t avoid, may also raise cancer risk. And the danger has grown over time.

Changes in building materials and household products have introduced new chemical hazards into fire environments, making modern fires more toxic than fires a generation ago.

WHO now classifies firefighting itself as carcinogenic

In 2022, the World Health Organization’s International Agency for Research on Cancer (IARC) put firefighting in its highest risk category, Group 1, meaning it classifies the occupation itself as carcinogenic to humans.

The agency based that decision on strong evidence linking firefighting to mesothelioma and bladder cancer.

It also found some evidence connecting the job to colon, prostate, and testicular cancers, along with skin melanoma.

That was a big upgrade from IARC’s 2007 rating, which had called firefighting only “possibly carcinogenic.”

Major study found higher cancer death rates

A July 2025 study led by the American Cancer Society compared cancer death rates among more than 470,000 firefighters to those of non-firefighter workers.

Firefighters showed a roughly 58% higher death rate from skin cancer and about 40% higher from kidney cancer. The study tracked cancer-free participants for 36 years.

Firefighters with longer careers faced even higher risks for prostate and colorectal cancer. Researchers stressed the importance of protective equipment and access to early cancer screening.

National registry now tracks over 40,000 firefighters

The CDC’s National Firefighter Registry for Cancer hit a milestone in February 2026, surpassing 40,000 enrolled firefighters. That makes it the largest firefighter cancer research group in the country.

The registry collects detailed work history data and links it with state cancer records. Any U.S. firefighter can enroll, whether career or volunteer, active or retired, with or without a cancer diagnosis.

The goal is to better understand how firefighting activities connect to cancer over time.

Other states take different approaches

Nearly all U.S. states now have some form of firefighter cancer presumption law.

Those laws shift the burden of proof so that firefighters diagnosed with certain cancers can presume the job caused them. But coverage varies widely, and many states leave out volunteers.

Maryland’s Malone Act takes a different approach: it focuses on screening, not compensation after diagnosis.

Nevada’s SB 170, signed in July 2025, goes further by requiring annual employer-paid screenings for both career and volunteer firefighters starting in July 2026.

Early detection drives the push forward

Supporters of the Malone Act say catching cancer early gives firefighters the best chance at survival.

Cancers tied to occupational exposure can take years or even decades to show up, which makes regular screening critical.

The law is one piece of a broader national effort to protect firefighter health through proactive screening rather than only reactive benefits.

The Dec. 2028 report from the Maryland Health Care Commission may shape future legislation in Maryland and could serve as a model for other states.

This article was created with AI assistance and human editing.

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