Malignant neoplasm of the colon and rectum — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 19 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 malignant neoplasm of the colon or rectum or death from malignant neoplasm of the colon or rectum with the circumstances of a person's relevant service:

1. (1)
   having familial adenomatous polyposis before the clinical onset of malignant neoplasm of the colon or rectum;
2. (2)
   having a colorectal adenoma involving the affected part of the colon or rectum before the clinical onset of malignant neoplasm of the colon or rectum;
3. (3)
   being prevented from accessing clinical screening for colorectal precancerous lesions or colorectal cancer in accordance with contemporary medical standards of the time, within the 5 years before the clinical onset of malignant neoplasm of the colon or rectum, and: (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: colorectal precancerous lesions is defined in the Schedule 1 - Dictionary.

4. (4)
   being prevented from accessing appropriate treatment for colorectal precancerous lesions in accordance with contemporary medical standards of the time, within the 5 years before the clinical onset of malignant neoplasm of the colon or rectum;

   Note: colorectal precancerous lesions is defined in the Schedule 1 - Dictionary.

5. (5)
   having inflammatory bowel disease involving the colon or rectum for at least 3 years before the clinical onset of malignant neoplasm of the colon or rectum;
6. (6)
   undergoing a course of therapeutic radiation for cancer, where the affected part of the colon or rectum was in the field of radiation, before the clinical onset of malignant neoplasm of the colon or rectum;
7. (7)
   having received a cumulative equivalent dose of at least 0.1 sievert of ionising radiation to the colon or rectum at least 5 years before the clinical onset of malignant neoplasm of the colon or rectum;

   Note: cumulative equivalent dose is defined in the Schedule 1 - Dictionary.

8. (8)
   inhaling respirable asbestos fibres in an enclosed space, at the time material containing asbestos was being applied, removed, cut, drilled, dislodged or disturbed: (a) for a cumulative period of at least 1,000 hours before the clinical onset of malignant neoplasm of the colon or rectum; and (b) where the first inhalation of asbestos fibres commenced at least 5 years before the clinical onset of malignant neoplasm of the colon or rectum;

   Note: Disturbance of debris or dust contaminated with asbestos fibres already present in an enclosed space may result in exposure to respirable asbestos fibres.

9. (9)
   inhaling respirable asbestos fibres in an open environment, at the time material containing asbestos was being applied, removed, cut, drilled, dislodged or disturbed: (a) for a cumulative period of at least 3,000 hours before the clinical onset of malignant neoplasm of the colon or rectum; and (b) where the first inhalation of asbestos fibres commenced at least 5 years before the clinical onset of malignant neoplasm of the colon or rectum;

   Note: Disturbance of debris or dust contaminated with asbestos fibres already present in an open environment may result in exposure to respirable asbestos fibres.

10. (10)
    having smoked tobacco products: (a) in an amount of at least 15 pack-years before the clinical onset of malignant neoplasm of the colon or rectum; and (b) commencing at least 5 years before the clinical onset of malignant neoplasm of the colon or rectum; and if smoking has ceased before the clinical onset of malignant neoplasm of the colon or rectum, then that onset occurred within 30 years of cessation;

    Note: one pack-year is defined in the Schedule 1 - Dictionary.

11. (11)
    consuming at least 250 kilograms of alcohol before the clinical onset of malignant neoplasm of the colon or rectum;

    Note: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.

12. (12)
    being overweight or obese for at least 5 years within the 30 years before the clinical onset of malignant neoplasm of the colon or rectum;

    Note: being overweight or obese is defined in the Schedule 1 - Dictionary.

13. (13)
    having diabetes mellitus for at least 5 years before the clinical onset of malignant neoplasm of the colon or rectum;
14. (14)
    having a solid organ transplant at least 5 years before the clinical onset of malignant neoplasm of the colon or rectum;
15. (15)
    having chronic schistosomiasis involving the affected part of the colon or rectum for at least 5 years before the clinical onset of malignant neoplasm of the colon or rectum;
16. (16)
    having a ureterosigmoidostomy involving the affected part of the sigmoid colon at least 5 years before the clinical onset of malignant neoplasm of the colon or rectum;
17. (17)
    having psoriasis at the time of the clinical onset of malignant neoplasm of the colon or rectum;
18. (18)
    having sarcoidosis at the time of the clinical onset of malignant neoplasm of the colon or rectum;
19. (19)
    having bilateral oophorectomy at least 5 years before the clinical onset of malignant neoplasm of the colon or rectum;
20. (20)
    having bilateral orchiectomy at least 5 years before the clinical onset of malignant neoplasm of the colon or rectum;
21. (21)
    having androgen deprivation therapy at least 5 years before the clinical onset of malignant neoplasm of the colon or rectum;
22. (22)
    inability to consume an average of at least of 20 grams per day of fibre in food for at least 5 consecutive years within the 25 years before the clinical onset of malignant neoplasm of the colon or rectum;

    Note: fibre in food is defined in the Schedule 1 - Dictionary.

23. (23)
    inability to consume an average of at least 100 millilitres per day of dairy milk for at least 5 consecutive years within the 25 years before the clinical onset of malignant neoplasm of the colon or rectum;
24. (24)
    for malignant neoplasm 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 malignant neoplasm of the colon; (b) having acromegaly before the clinical onset of malignant neoplasm of the colon; (c) consuming an average of at least 100 grams per day of red meat, for at least 10 years within the 25 years before the clinical onset of malignant neoplasm of the colon; (d) consuming an average of at least 25 grams per day of processed meat product, for at least 10 years within the 25 years before the clinical onset of malignant neoplasm 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 malignant neoplasm of the colon; or (f) having a cholecystectomy at least 5 years before the clinical onset of malignant neoplasm of the colon;

    Note: MET is defined in the Schedule 1 - Dictionary.

    Note: acromegaly is defined in the Schedule 1 - Dictionary.

    Note: red meat is defined in the Schedule 1 - Dictionary.

    Note: processed meat product is defined in the Schedule 1 - Dictionary.

25. (25)
    inability to obtain appropriate clinical management for malignant neoplasm of the colon or rectum;

Aggravation-only factors: the factors in subsection 9(25) 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.