Instrument No.43 of 1997
Revocation and Determination
of
Statement of Principles
concerning
MALIGNANT NEOPLASM OF THE OVARY
ICD CODES: 183.0, 236.2
Veterans’ Entitlements Act 1986
1. The Repatriation Medical Authority under subsection 196B(2) of the Veterans’ Entitlements Act 1986 (the Act):
(a) revokes Instrument No.131 of 1995; and
(b) determines the following Statement of Principles.
Kind of injury, disease or death
2. (a) This Statement of Principles is about malignant neoplasm of the ovary and death from malignant neoplasm of the ovary.
(b) For the purposes of this Statement of Principles, “malignant neoplasm of the ovary” means a primary malignant neoplasm arising from the cells of the ovary and including cell types of borderline malignant potential, attracting ICD code 183.0 or 236.2;
Note: For the purposes of this Statement of Principles, this definition specifically excludes soft tissue sarcoma, non-Hodgkin's lymphoma and Hodgkin's disease.
Note to user (this note does not form part of the legal wording of the instrument):
In the event that a disease referred to in the note above (which is excluded from coverage by this Statement of Principles) is claimed, reference should be made to the relevant Statement of Principles (or Statements of Principles) which cover or refer to that disease (if any).
Basis for determining the factors
3. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that malignant neoplasm of the ovary and death from malignant neoplasm of the ovary can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces.
Factors that must be related to service
4. Subject to clause 6, the factors set out in at least one of the paragraphs in clause 5 must be related to any relevant service rendered by the person.
Factors
5. The factors that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting malignant neoplasm of the ovary or death from malignant neoplasm of the ovary with the circumstances of a person’s relevant service are:
(a) for epithelial ovarian cancer only, being nulliparous at the time of the clinical onset of malignant neoplasm of the ovary, unless the nulliparous state is attributable to treatment with the oral contraceptive pill or to tubal ligation or hysterectomy; or
(b) inability to obtain appropriate clinical management for the malignant neoplasm of the ovary.
Factors that apply only to material contribution or aggravation
6. Paragraph 5(b) applies only to material contribution to, or aggravation of, malignant neoplasm of the ovary where the person’s malignant neoplasm of the ovary was suffered or contracted before or during (but not arising out of) the person’s relevant service; paragraph 8(1)(e), 9(1)(e), 70(5)(d) or 70(5A)(d) of the Act refers.
Other definitions
7. For the purposes of this Statement of Principles:
“epithelial ovarian cancer” means a primary malignant neoplasm arising from epithelial ovarian tissues, which includes:
(i) malignant serous tumours of the ovary (such as adenocarcinoma); or
(ii) malignant mucinous tumours of the ovary; or
(iii) malignant endometroid tumours of the ovary; or
(iv) malignant clear cell tumours; or
(v) malignant Brenner tumours; or
(vi) undifferentiated carcinoma of the ovary; and
excludes sex cord-stromal tumours and germ cell tumours of the ovary;
“hysterectomy” means the surgical operation of total or subtotal excision of the uterus, performed either through the abdominal wall or through the vagina;
“ICD code” means a number assigned to a particular kind of injury or disease in the Australian Version of The International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM), effective date of 1 July 1996, copyrighted by the National Coding Centre, Faculty of Health Sciences, University of Sydney, NSW, and having ISBN 0 642 24447 2;
“nulliparous” means having never given birth to a viable infant;
“oral contraceptive pill” means a compound taken in order to block ovulation and prevent the occurrence of pregnancy;
“relevant service” means:
(a) operational service; or
(b) peacekeeping service; or
(c) hazardous service;
“tubal ligation” means the surgical procedure to the fallopian tubes to interfere with egg transmission between the ovary and the uterus as a form of contraception.
Application
8. This Instrument applies to all matters to which section 120A of the Act applies.
Dated this Second day of May 1997
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of: )
KEN DONALD
CHAIRMAN