Statement of Principles concerning malignant neoplasm of the small intestine No. 40 of 2004 (Cth)
Statement of Principles
Concerning
MALIGNANT NEOPLASM OF THE SMALL INTESTINE
Instrument No. 40 of 2004 as amended
made under section 196B(2) of the
Veterans’ Entitlements Act 1986
This compilation was prepared on 23 March 2010 taking into account Amendment of Statement of Principles concerning MALIGNANT NEOPLASM OF THE SMALL INTESTINE (Instrument No. 19 of 2010)
Prepared by the Repatriation Medical Authority Secretariat, Brisbane.
Statement of Principles
concerning
MALIGNANT NEOPLASM OF THE SMALL INTESTINE
for the purposes of the
Veterans’ Entitlements Act 1986
and
Military Rehabilitation and Compensation Act 2004
The Repatriation Medical Authority under subsection 196B(2) and (8) of the Veterans’ Entitlements Act 1986 (the VEA):
(a) revokes Instrument No. 153 of 1996, as amended by Instrument No. 7 of 1998; and
(b) determines in their place the following Statement of Principles.
Kind of injury, disease or death
(a) This Statement of Principles is about malignant neoplasm of the small intestine and death from malignant neoplasm of the small intestine.
(b)For the purposes of this Statement of Principles, "malignant neoplasm of the small intestine " means a primary malignant neoplasm arising from the epithelial cells of the small intestine. The small intestine is defined as the proximal portion of the intestine comprising the duodenum, jejunum and ileum, excluding the pyloric opening of the stomach and the ileocaecal junction. This definition excludes soft tissue sarcoma, carcinoid tumour, non-Hodgkin’s lymphoma and Hodgkin’s lymphoma.
(c)Malignant neoplasm of the small intestine attracts ICD-10-AM code C17.
(d)In the application of this Statement of Principles, the definition of "malignant neoplasm of the small intestine " is that given at paragraph 2(b) above.
Basis for determining the factors
The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that malignant neoplasm of the small intestine and death from malignant neoplasm of the small intestine can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces under the VEA, or members under the Military Rehabilitation and Compensation Act 2004 (the MRCA).
Factors that must be related to service
Subject to clause 6, at least one of the factors set out in clause 5 must be related to the relevant service rendered by the person.
Factors
The factor that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting malignant neoplasm of the small intestine or death from malignant neoplasm of the small intestine with the circumstances of a person’s relevant service is:
(a)having Crohn’s disease of the small intestine before the clinical onset of malignant neoplasm of the small intestine; or
(b) having coeliac disease before the clinical onset of malignant neoplasm of the small intestine; or
(c)having an adenoma of the small intestine before the clinical onset of malignant neoplasm of the small intestine; or
(d)for adenocarcinoma involving an ileostomy or ileal pouch only, having an ileostomy or ileal pouch for at least two years before the clinical onset of malignant neoplasm of the small intestine; or
(da) consuming at least 300 grams per week of specified food for at least 20 years, before the clinical onset of malignant neoplasm of the small intestine; or
(db) for carcinoma of the first part of the duodenum only, being infected with Helicobacter pylori for at least 10 years, before the clinical onset of malignant neoplasm of the small intestine; or
(dc)drinking at least 25 grams per day of alcohol from beer or spirits for at least 20 years, before the clinical onset of malignant neoplasm of the small intestine; or
(dd) for males only, being obese for at least 10 years before the clinical onset of malignant neoplasm of the small intestine; or
(e)inability to obtain appropriate clinical management for malignant neoplasm of the small intestine.
Factors that apply only to material contribution or aggravation
Paragraph 5(e) applies only to material contribution to, or aggravation of, malignant neoplasm of the small intestine where the person’s malignant neoplasm of the small intestine was suffered or contracted before or during (but not arising out of) the person’s relevant service.
Inclusion of Statements of Principles
In this Statement of Principles if a relevant factor applies and that factor includes an injury or disease in respect of which there is a Statement of Principles then the factors in that last mentioned Statement of Principles apply in accordance with the terms of that Statement of Principles.
Other definitions
For the purposes of this Statement of Principles:
"alcohol" is measured by the alcohol consumption calculations utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink;
"being obese" means an increase in body weight by way of fat accumulation which results in a Body Mass Index (BMI) of 30 or greater.
The BMI = W/H2 and where:
W is the person’s weight in kilograms and
H is the person’s height in metres:
"Crohn's disease" means a type of inflammatory bowel disease affecting any part of the gastrointestinal tract, which is characterised by chronic inflammation which may extend through all layers of the gastrointestinal tract wall, and is also known as regional enteritis;
"death from malignant neoplasm of the small intestine " in relation to a person includes death from a terminal event or condition that was contributed to by the person’s malignant neoplasm of the small intestine;
"ICD-10-AM code" means a number assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian Modification (ICD-10-AM), Fourth Edition, effective date of 1 July 2004, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 594 1;
"relevant service" means:
(a) operational service under the VEA; or
(b) peacekeeping service under the VEA; or
(c)hazardous service under the VEA; or
(d)warlike service under the MRCA; or
(e)non-warlike service under the MRCA;
"specified food" means salt-cured or smoked food; or meat or fish which has been fried, barbecued, salt-cured or smoked;
"terminal event" means the proximate or ultimate cause of death and includes:
(a) pneumonia;
(b) respiratory failure;
(c) cardiac arrest;
(d) circulatory failure; or
(f)cessation of brain function.
Application
This Instrument applies to all matters to which section 120A of the VEA or section 338 of the MRCA applies.
Notes to Statement of Principles concerning malignant neoplasm of the small intestine (Instrument No. 40 of 2004)
The Statement of Principles concerning malignant neoplasm of the small intestine (Instrument No. 40 of 2004) in force under section 196B(2) of the Veterans’ Entitlements Act 1986, as shown in this compilation is amended as indicated in the Tables below.
Table of Instruments
| Title | Date of notification | Date of | Application, saving or |
| Statement of Principles concerning malignant neoplasm of the small intestine (Instrument No. 40 of 2004) | 17 November 2004 (see Gazette 2004, No. GN46) | 17 November 2004 | |
| Amendment of Statement of Principles concerning malignant neoplasm of the small intestine (Instrument No. 19 of 2010) | 10 March 2010 | 19 August 2009 |
Table of Amendments
| ad. = added or inserted am. = amended rep. = repealed rs. = repealed and substituted | |
| Provision affected | How affected |
| Clause 5 – ‘(da)'...... | ad. Instrument No. 19 of 2010 |
| Clause 5 – ‘(db)'…... | ad. Instrument No. 19 of 2010 |
| Clause 5 – ‘(dc)'…… | ad. Instrument No. 19 of 2010 |
| Clause 5 – ‘(dd)’…… | ad. Instrument No. 19 of 2010 |
| Clause 8 – definition for "alcohol" ……. | ad. Instrument No. 19 of 2010 |
| Clause 8 – definition for "being obese"….. | ad. Instrument No. 19 of 2010 |
| Clause 8 – definition for "specified food"…… | ad. Instrument No. 19 of 2010 |
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