Cancer case highlights gaps in Texas protections for women firefighters

NEW BRAUNFELS, Texas (KXAN) — Between carpool, homework, and after-school activities for her two teenage daughters, Suzanne La Follette fits in chemo.

As she and her partner move through daily life, they’ve had to navigate cancer treatments and a legal system surrounding workers’ compensation.

“To have this on top of it has been really overwhelming,” La Follette said.

The Austin Fire Department lieutenant of nearly two decades said she was diagnosed with terminal uterine cancer last May. She explained in November 2025, the City of Austin denied her workers’ compensation claim, classifying her cancer as a “disease of life” rather than an illness tied to her work as a firefighter.

“I have no regrets (about) becoming a firefighter,” La Follette said. “But I do think this job absolutely caused the cancer.”

Her case highlights concerns by firefighter associations across the state and the need to strengthen Texas’ presumptive cancer laws, particularly to ensure women firefighters are covered.

Focus on cancers impacting women

La Follette, 46, appealed the city’s decision.

In April, a ruling affirmed that her cancer is occupational, making her eligible for workers’ compensation benefits. A city spokesperson said it’s not appealing the judge’s decision. 

“All workers’ compensation claims are unique and evaluated on a case-by-case basis. This process ensured that Lt. La Follette’s case was reviewed and considered by a neutral third party,” said the statement to KXAN investigators. “We are thankful for the clarity provided by the Texas Division of Workers’ Compensation and appreciate Lt. La Follette’s years of service to this community.”

Under Texas law, certain cancers are presumed to be job-related for firefighters, but cancers specifically impacting women, including uterine cancer, are not listed.

It’s why state lawmakers want to study the issue and have directed the Department of State Health Services and the Texas Commission on Fire Protection to compare cancer rates of women firefighters across the state to other women, focusing on ovarian, cervical, uterine and breast cancers. A report due to the Texas legislature by September must include the results of the study and any recommendations. 

DSHS said the agency is using Texas Cancer Registry data to compare all cancers, and those specific to women, among women who are firefighters and those who are not. The Texas Commission on Fire Protection explained the agency has shared data with the state health department on more than 40,000 firefighters in Texas to correlate the data, which does not include occupations. The data will allow DSHS to identify women employed as firefighters.

“There have been many studies which show a link to increased risk of cancer amongst male firefighters for a broad range of cancers; however, until now, there were not enough female firefighters in the state to do a meaningful study into the increased risk these women face to female-specific cancers, such as ovarian and breast cancers,” said State Rep. Jared Patterson, R-Frisco, one of the authors of the legislation which became law last legislative session.

Patterson said the new law does not change existing code or policy, but the state will study whether certain cancers should be added to preemptive measures, as other specific cancers have been.

‘Left by the wayside’

Firefighter associations are advocating for statewide changes to cancer protections for firefighters.

“They could get it through the exposure to carcinogens on the fire ground, benzene, diesel exhaust in the fire station, if they don’t have that taken care of,” explained John Riddle, president of the Texas State Association of Fire Fighters.

The association has almost 21,000 members and points to gaps in research, which has historically focused on men. 

“They’ve (women) been kind of left by the wayside quite frankly over the years,” said Riddle. “And we need to fix that.”

Though the number of studies into cancer rates impacting female firefighters are limited, one out of Florida is similar to what Texas is hoping to learn. 

A study published in the American Journal of Industrial Medicine in 2020 examined cancer risk in over 100,000 Florida firefighters over three decades.

The study found women firefighters had a 154% increased risk of brain cancer, a 142% increased risk of thyroid cancer and a 68% greater risk of melanoma compared to women who were not firefighters. The authors of the study explained more research is needed to focus on a larger number of women firefighters diagnosed with cancer. 

It’s what another national study currently underway hopes to do. 

The Fire Fighter Cancer Cohort Study, funded by the Federal Emergency Management Agency, is focusing on women firefighters and evaluating factors associated with the increased risk for cancer, reproductive health outcomes and stress in the fire service. As of early May, more than 1,400 women firefighters have enrolled in the study from across the country, over 170 from Texas. 

“I’ve really been optimistic that we can make some change,” La Follette said, hearing about the ongoing studies. “The more research we gather, the more we realize… that cancer is an occupational hazard of firefighting.”