Malignant neoplasm of the nasopharynx

Source: Repatriation Medical Authority Statements of Principles as held by the Veterans Health Centre. SoPs are amended and replaced regularly; always confirm the current instrument at rma.gov.au before relying on it.

RH No. 9 of 2020 · BoP No. 10 of 202021 factors

Meaning of malignant neoplasm of the nasopharynx: For the purposes of this Statement of Principles, malignant neoplasm of the nasopharynx: (a) means a primary malignancy of the mucosa of the nasopharynx, which extends from the nares (nostrils) to that part of the pharynx which lies above the level of the soft palate; and (b) excludes: (i) carcinoid (neuroendocrine) tumour; (ii) Hodgkin's lymphoma; (iii) malignant neoplasm of the oral cavity, oropharynx and hypopharynx; (iv) malignant neoplasm of the larynx; (v) non-Hodgkin lymphoma; and (vi) soft tissue sarcoma. (3) While malignant neoplasm of the nasopharynx attracts ICD-10-AM code C11, in applying this Statement of Principles the meaning of malignant neoplasm of the nasopharynx 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. 9 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 nasopharynx or death from malignant neoplasm of the nasopharynx with the circumstances of a person's relevant service:

(1)
having infection with the Epstein-Barr virus before the clinical onset of malignant neoplasm of the nasopharynx;
(2)
having infection with human immunodeficiency virus before the clinical onset of malignant neoplasm of the nasopharynx;
(3)
smoking at least 15 pack-years of cigarettes, or the equivalent thereof in other tobacco products, before the clinical onset of malignant neoplasm of the nasopharynx, and: (a) smoking commenced at least 15 years before the clinical onset of malignant neoplasm of the nasopharynx; and (b) where smoking has ceased, the clinical onset of malignant neoplasm of the nasopharynx has occurred within 15 years of cessation;
Note: pack-years of cigarettes, or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary.
(4)
consuming at least 500 kilograms of alcohol before the clinical onset of malignant neoplasm of the nasopharynx;
Note: Alcohol consumption is calculated utilising the Australian Standard of ten grams of alcohol per standard alcoholic drink.
(5)
being exposed to mustard gas at least five years before the clinical onset of malignant neoplasm of the nasopharynx;
(6)
inhaling wood dust for at least four hours per day on more days than not for at least ten years or for a cumulative period of at least 7 500 hours before the clinical onset of malignant neoplasm of the nasopharynx;
Note: inhaling wood dust is defined in the Schedule 1 - Dictionary.
(7)
inhaling formaldehyde for a cumulative total of at least 750 hours: (a) at a level of at least one part per million; or (b) resulting in sensory irritation of the eyes or nose; at least 15 years before the clinical onset of malignant neoplasm of the nasopharynx;
(8)
inhaling smoke from the combustion of wood, charcoal or coal while in an enclosed space, on more days than not for at least ten years or for a cumulative period of at least 7 500 hours, before the clinical onset of malignant neoplasm of the nasopharynx;
(9)
consuming an average of at least ten grams per week of Chinese-style salted fish for at least five consecutive years within the 20 years before the clinical onset of malignant neoplasm of the nasopharynx;
Note: Chinese-style salted fish is defined in the Schedule 1 - Dictionary.
(10)
consuming an average of at least 75 grams per week of preserved vegetables for at least five consecutive years within the 20 years before the clinical onset of malignant neoplasm of the nasopharynx;
Note: preserved vegetables is defined in the Schedule 1 - Dictionary.
(11)
an inability to consume an average of at least 100 grams per day of any combination of fresh fruit and vegetables for a period of at least five consecutive years within the 20 years before the clinical onset of malignant neoplasm of the nasopharynx;
(12)
having chronic sinusitis or chronic rhinitis before the clinical onset of malignant neoplasm of the nasopharynx;
(13)
inability to obtain appropriate clinical management for malignant neoplasm of the nasopharynx;

Aggravation-only factors: the factors in subsection 9(13) 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. 10 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 nasopharynx or death from malignant neoplasm of the nasopharynx is connected with the circumstances of a person's relevant service:

(1)
having infection with the Epstein-Barr virus before the clinical onset of malignant neoplasm of the nasopharynx;
(2)
smoking at least 20 pack-years of cigarettes, or the equivalent thereof in other tobacco products, before the clinical onset of malignant neoplasm of the nasopharynx, and: (a) smoking commenced at least 20 years before the clinical onset of malignant neoplasm of the nasopharynx; and (b) where smoking has ceased, the clinical onset of malignant neoplasm of the nasopharynx has occurred within ten years of cessation;
Note: pack-years of cigarettes, or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary.
(3)
being exposed to mustard gas at least five years before the clinical onset of malignant neoplasm of the nasopharynx;
(4)
inhaling wood dust for at least four hours per day on more days than not for at least 20 years or for a cumulative period of at least 15 000 hours before the clinical onset of malignant neoplasm of the nasopharynx;
Note: inhaling wood dust is defined in the Schedule 1 - Dictionary.
(5)
inhaling formaldehyde for a cumulative total of at least 1 500 hours: (a) at a level of at least one part per million; or (b) resulting in sensory irritation of the eyes or nose; at least 15 years before the clinical onset of malignant neoplasm of the nasopharynx;
(6)
consuming an average of at least ten grams per week of Chinese-style salted fish for at least five consecutive years within the 20 years before the clinical onset of malignant neoplasm of the nasopharynx;
Note: Chinese-style salted fish is defined in the Schedule 1 - Dictionary.
(7)
consuming an average of at least 75 grams per week of preserved vegetables for at least five consecutive years within the 20 years before the clinical onset of malignant neoplasm of the nasopharynx;
Note: preserved vegetables is defined in the Schedule 1 - Dictionary.
(8)
inability to obtain appropriate clinical management for malignant neoplasm of the nasopharynx;

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.

Malignant neoplasm of the nasopharynx — DVA SoP factors