When Frank Dreckman walked into his doctor's office to schedule a colonoscopy in 2007, he was in the best shape of his life.

He decided to go at the urging of his wife and almost rejected the annual physical his doctor offered while he was there.

The captain at Poudre Fire Authority definitely wasn't expecting to hear anything about his prostate, let alone receive a cancer diagnosis.

Nor was he planning to embark on a precedent-setting legal battle with his workers' compensation insurance agency. That journey ended in 2009 when Dreckman won one of the first civil cases heard in Colorado involving the state's cancer presumption law. In 2007, that statute established a presumption in the state workers' compensation system that certain cancers experienced by firefighters are caused by their work, as long as the firefighter worked in that role for at least five years.

Today, Dreckman is a cancer survivor and firefighter safety officer. Part of his role includes ensuring firefighters are doing everything they can to reduce their risks of developing cancer, or as he puts it, being "the person that kind of watches their backs."

Over the past decade especially, fire departments across the nation have recognized the increased likelihood of cancer in firefighters and have implemented policies and the use of specific equipment to reduce those risks.

A 2015 study by the National Institute for Occupational Safety and Health found that firefighters showed higher rates of certain cancers than the general population, including digestive, oral, respiratory and urinary cancers. They were also twice as likely to have malignant mesothelioma, a cancer caused by exposure to asbestos.

"This data has changed firefighter behavior," Poudre Fire Authority Chief Tom Demint said.

The latest addition for Poudre Fire Authority is still in its testing phase: new hoods, which some firefighters received in the spring. They're more costly but provide more protection.

Dreckman recalls buying a racing hood to wear into fires when he started with PFA — he was the first to wear a hood in the department. Previously, firefighters just used their ears as temperature gauges to tell them when to get out of a fire, Capt. Dustin DeBaere said.

Battalion Chief Gary Nuckols said a lot of what has changed over the years is related to decontaminating gear after a fire. Some departments even give each firefighter two sets of gear so a clean set is always at the ready.

"Every single one of (the procedures) has been met with some resistance, but try to take any away from (firefighters) now; there would be an uproar," Nuckols said.

Reducing the risk of toxins and carcinogens from fires is about known risks and also what firefighters don't know, Nuckols said. As materials in homes have changed and more synthetics are used, Demint said, toxins from fires are presumed to be more harmful than they were previously.

Nuckols acknowledges there was an image firefighters had to get past to make some of these changes: "Dirty gear looks really cool."

But as data began to support the theories about increased cancer risk, and as firefighters across the nation shared their stories, it wasn't hard to get PFA firefighters to adopt the new ideas, Nuckols said.

The change he thought firefighters would push against the hardest was wearing their 30-pound air packs for sometimes an additional hour, "but people just did it."

And Colorado has taken more legislative action to ensure firefighters who do develop cancer are taken care of.

The establishment of a trust for firefighters who have developed cancer and heart issues has been lauded by departments across the state, Demint said. Departments can pay into the trust, which helps firefighters who need the money to offset out-of-pocket expenses for care.