Colorectal adenoma
Meaning of colorectal adenoma: For the purposes of this Statement of Principles, colorectal adenoma: (a) means a benign neoplasm arising from the epithelial cells of the colorectum; and (b) includes: (i) adenomatous polyp; (ii) sessile serrated adenoma; and (iii) traditional serrated adenoma; and (c) excludes: (i) benign neoplasms of the anus and anal canal; (ii) familial adenomatous polyposis; (iii) non-neoplastic polyps of the colon; (iv) nonepithelial neoplasms of the colon; and (v) non-polypoid dysplasia. (3) While colorectal adenoma attracts ICD-10-AM code D12.0, D12.1, D12.2, D12.3, D12.4, D12.5, D12.7 or D12.8, in applying this Statement of Principles the meaning of colorectal adenoma is that given in subsection (2). (4) For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4.
Reasonable Hypothesis (RH) — Statement of Principles No. 15 of 2022
At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting colorectal adenoma or death from colorectal adenoma with the circumstances of a person's relevant service:
- (1)having smoked tobacco products: (a) in an amount of at least 10 pack-years before the clinical onset of colorectal adenoma; and (b) commencing at least 5 years before the clinical onset of colorectal adenoma; and if smoking has ceased before the clinical onset of colorectal adenoma, then that onset occurred within 30 years of cessation;
Note: one pack-year is defined in the Schedule 1 - Dictionary.
- (2)consuming at least 250 kilograms of alcohol before the clinical onset of colorectal adenoma;
Note: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.
- (3)being overweight or obese for at least 5 years within the 30 years before the clinical onset of colorectal adenoma;
Note: being overweight or obese is defined in the Schedule 1 - Dictionary.
- (4)having diabetes mellitus for at least 5 years before the clinical onset of colorectal adenoma;
- (5)inability to consume an average of at least 20 grams per day of fibre in food, for at least 5 consecutive years within the 10 years before the clinical onset of colorectal adenoma;
Note: fibre in food is defined in the Schedule 1 - Dictionary.
- (6)having a solid organ transplant at least 5 years before the clinical onset of colorectal adenoma;
- (7)having a ureterosigmoidostomy involving the affected part of the colorectum at least 5 years before the clinical onset of colorectal adenoma;
- (8)for adenoma of the colon only: (a) inability to undertake any physical activity greater than 3 METs for at least 10 consecutive years within the 30 years before the clinical onset of adenoma of the colon; (b) having acromegaly before the clinical onset of adenoma of the colon; (c) consuming an average of at least 100 grams per day of red meat, for at least 5 years within the 10 years before the clinical onset of adenoma of the colon; (d) consuming an average of at least 25 grams per day of processed meat product, for at least 5 years within the 10 years before the clinical onset of adenoma of the colon; (e) inability to consume an average of at least 100 grams per day of any combination of fruit and vegetables, for at least the 5 years before the clinical onset of adenoma of the colon;
Note: adenoma of the colon and MET are defined in the Schedule 1 - Dictionary.
Note: acromegaly and adenoma of the colon are defined in the Schedule 1 - Dictionary.
Note: adenoma of the colon and red meat are defined in the Schedule 1 - Dictionary.
Note: adenoma of the colon and processed meat product are defined in the Schedule 1 - Dictionary.
Note: adenoma of the colon is defined in the Schedule 1 - Dictionary.
- (9)inability to obtain appropriate clinical management for colorectal adenoma;
Aggravation-only factors: the factors in subsection 9(9) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
Balance of Probabilities (BoP) — Statement of Principles No. 16 of 2022
7 factors
At least one of the following factors must exist before it can be said that, on the balance of probabilities, colorectal adenoma or death from colorectal adenoma is connected with the circumstances of a person's relevant service:
- (1)having smoked tobacco products: (a) in an amount of at least 20 pack-years before the clinical onset of colorectal adenoma; and (b) commencing at least 5 years before the clinical onset of colorectal adenoma; and if smoking has ceased before the clinical onset of colorectal adenoma, then that onset occurred within 15 years of cessation;
Note: one pack-year is defined in the Schedule 1 - Dictionary.
- (2)consuming at least 500 kilograms of alcohol before the clinical onset of colorectal adenoma;
Note: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.
- (3)being obese for at least 10 years within the 30 years before the clinical onset of colorectal adenoma;
Note: being obese is defined in the Schedule 1 - Dictionary.
- (4)having diabetes mellitus for at least 5 years before the clinical onset of colorectal adenoma;
- (5)inability to consume an average of at least 20 grams per day of fibre in food, for at least 5 consecutive years within the 10 years before the clinical onset of colorectal adenoma;
Note: fibre in food is defined in the Schedule 1 - Dictionary.
- (6)for adenoma of the colon only: (a) inability to undertake any physical activity greater than 3 METs for at least 10 consecutive years within the 30 years before the clinical onset of adenoma of the colon; (b) consuming an average of at least 100 grams per day of red meat, for at least 5 years within the 10 years before the clinical onset of adenoma of the colon; (c) consuming an average of at least 25 grams per day of processed meat product, for at least 5 years within the 10 years before the clinical onset of adenoma of the colon;
Note: adenoma of the colon and MET are defined in the Schedule 1 - Dictionary.
Note: adenoma of the colon and red meat are defined in the Schedule 1 - Dictionary.
Note: adenoma of the colon and processed meat product are defined in the Schedule 1 - Dictionary.
- (7)inability to obtain appropriate clinical management for colorectal adenoma;
Aggravation-only factors: the factors in subsection 9(7) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
