Malignant neoplasm of the cervix
Meaning of malignant neoplasm of the cervix: For the purposes of this Statement of Principles, malignant neoplasm of the cervix: (a) means a primary invasive carcinoma, carcinoma in situ, adenocarcinoma in situ or cervical intraepithelial neoplasia grade 3, arising from the cells of the cervix uteri; and (b) includes squamous cell carcinoma, adenocarcinoma and adenosquamous carcinoma; and (c) excludes: (i) cervical intraepithelial neoplasia grades 1 or 2; (ii) malignant melanoma and melanoma in situ; (iii) neuroendocrine tumours; and (iv) soft tissue sarcoma, adenosarcoma, carcinosarcoma, non-Hodgkin lymphoma and Hodgkin's lymphoma. (3) While malignant neoplasm of the cervix attracts ICD-10-AM code C53 or D06, in applying this Statement of Principles the meaning of malignant neoplasm of the cervix 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-
Reasonable Hypothesis (RH) — Statement of Principles No. 80 of 2020
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 malignant neoplasm of the cervix or death from malignant neoplasm of the cervix with the circumstances of a person's relevant service:
- (1)having a persistent infection of the cervical epithelium with a specified human papillomavirus before the clinical onset of malignant neoplasm of the cervix;
Note: persistent infection and specified human papillomavirus are defined in the Schedule 1 - Dictionary.
- (2)having infection with human immunodeficiency virus before the clinical onset of malignant neoplasm of the cervix;
- (3)for squamous cell carcinoma of the cervix only, having smoked at least 10 pack-years of tobacco products, at least two years before the clinical onset of squamous cell carcinoma of the cervix, and where smoking has ceased, the clinical onset of squamous cell carcinoma of the cervix has occurred within 20 years of cessation;
Note: pack-year of tobacco products is defined in the Schedule 1 - Dictionary.
- (4)taking a combined oral contraceptive pill for a continuous period of at least three years, commencing at least five years before the clinical onset of malignant neoplasm of the cervix, and where taking the combined oral contraceptive pill has ceased, the clinical onset of malignant neoplasm of the cervix has occurred within 15 years of cessation;
Note: combined oral contraceptive pill is defined in the Schedule 1 - Dictionary.
- (5)taking an immunosuppressive drug for organ or tissue transplantation at least two years before the clinical onset of malignant neoplasm of the cervix;
Note: organ or tissue transplantation is defined in the Schedule 1 - Dictionary.
- (6)having systemic lupus erythematosus within the five years before the clinical onset of malignant neoplasm of the cervix;
- (7)being prevented from accessing clinical screening for cervical precancerous lesions or cervical cancer in accordance with contemporary medical standards of the time, within the seven years before the clinical onset of malignant neoplasm of the cervix, and where: (a) if clinical screening has subsequently resumed, there has been no normal test result; and (b) the opportunity for subsequent clinical screening has not been declined;
Note: cervical precancerous lesions and clinical screening for cervical precancerous lesions or cervical cancer are defined in the Schedule 1 - Dictionary.
- (8)being prevented from accessing appropriate treatment for cervical precancerous lesions in accordance with contemporary medical standards of the time, between two and seven years before the clinical onset of malignant neoplasm of the cervix;
Note: cervical precancerous lesions is defined in the Schedule 1 - Dictionary.
- (9)inability to obtain appropriate clinical management for malignant neoplasm of the cervix;
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. 81 of 2020
8 factors
At least one of the following factors must exist before it can be said that, on the balance of probabilities, malignant neoplasm of the cervix or death from malignant neoplasm of the cervix is connected with the circumstances of a person's relevant service:
- (1)having a persistent infection of the cervical epithelium with a specified human papillomavirus before the clinical onset of malignant neoplasm of the cervix;
Note: persistent infection and specified human papillomavirus are defined in the Schedule 1 - Dictionary.
- (2)having infection with human immunodeficiency virus before the clinical onset of malignant neoplasm of the cervix;
- (3)for squamous cell carcinoma of the cervix only, having smoked at least 20 pack-years of tobacco products, at least two years before the clinical onset of squamous cell carcinoma of the cervix, and where smoking has ceased, the clinical onset of squamous cell carcinoma of the cervix has occurred within 15 years of cessation;
Note: pack-year of tobacco products is defined in the Schedule 1 - Dictionary.
- (4)taking a combined oral contraceptive pill for a continuous period of at least five years, commencing at least five years before the clinical onset of malignant neoplasm of the cervix, and where taking the combined oral contraceptive pill has ceased, the clinical onset of malignant neoplasm of the cervix has occurred within 15 years of cessation;
Note: combined oral contraceptive pill is defined in the Schedule 1 - Dictionary.
- (5)taking an immunosuppressive drug for organ or tissue transplantation at least two years before the clinical onset of malignant neoplasm of the cervix;
Note: organ or tissue transplantation is defined in the Schedule 1 - Dictionary.
- (6)being prevented from accessing clinical screening for cervical precancerous lesions or cervical cancer in accordance with contemporary medical standards of the time, within the seven years before the clinical onset of malignant neoplasm of the cervix, and where: (a) if clinical screening has subsequently resumed, there has been no normal test result; and (b) the opportunity for subsequent clinical screening has not been declined;
Note: cervical precancerous lesions and clinical screening for cervical precancerous lesions or cervical cancer are defined in the Schedule 1 - Dictionary.
- (7)being prevented from accessing appropriate treatment for cervical precancerous lesions in accordance with contemporary medical standards of the time, between two and seven years before the clinical onset of malignant neoplasm of the cervix;
Note: cervical precancerous lesions is defined in the Schedule 1 - Dictionary.
- (8)inability to obtain appropriate clinical management for malignant neoplasm of the cervix;
Aggravation-only factors: the factors in subsection 9(8) 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.
