Malignant neoplasm of the oral cavity, oropharynx and hypopharynx — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 65 of 2021

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 oral cavity, oropharynx or hypopharynx or death from malignant neoplasm of the oral cavity, oropharynx or hypopharynx with the circumstances of a person's relevant service:

1. (1)
   having smoked tobacco products: (a) in an amount of at least 2.5 pack-years before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx; and (b) commencing at least 5 years before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx; and Malignant Neoplasm Of The Oral Cavity, Oropharynx And Hypopharynx if smoking has ceased before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx, then that onset occurred within 15 years of cessation;

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

2. (2)
   having been exposed to second-hand smoke: (a) for at least 5,000 hours before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx; and (b) commencing at least 5 years before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx; and if exposure to second-hand smoke has ceased before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx, then that onset occurred within 15 years of cessation;

   Note: having been exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.

3. (3)
   the oral use of smokeless tobacco: (a) on more days than not; and (b) for at least 5 years before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx; and if the oral use of smokeless tobacco has ceased before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx, then that onset occurred within 15 years of cessation;

   Note: smokeless tobacco is defined in the Schedule 1 - Dictionary.

4. (4)
   chewing betel quid or areca nut: (a) in an amount of at least one betel quid or areca nut per day for a continuous period of at least 1 year before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx; and (b) commencing at least 5 years before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx; and if chewing of betel quid or areca nut has ceased before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx, then that onset occurred within 15 years of cessation; Malignant Neoplasm Of The Oral Cavity, Oropharynx And Hypopharynx;
5. (5)
   consuming maté: (a) on more days than not; and (b) for at least 5 years before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx; and if consumption of maté has ceased before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx, then that onset occurred within 15 years of cessation;
6. (6)
   consuming alcohol: (a) in an amount of at least 50 kilograms within any 10 year period; and (b) at least 5 years before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx; and if consumption of alcohol has ceased before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx, then that onset occurred within 40 years of cessation;

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

7. (7)
   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 oral cavity, oropharynx or hypopharynx; and (b) where the first inhalation of asbestos fibres commenced at least 5 years before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx;

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

8. (8)
   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 oral cavity, oropharynx or hypopharynx; and (b) where the first inhalation of asbestos fibres commenced at least 5 years before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx; Malignant Neoplasm Of The Oral Cavity, Oropharynx And Hypopharynx;

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

9. (9)
   being exposed to mustard gas at least 5 years before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx;
10. (10)
    acquiring persistent infection of the oral cavity epithelium or oropharyngeal epithelium with human papilloma virus type 16 or 18 before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx;
11. (11)
    having infection with human immunodeficiency virus before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx;
12. (12)
    taking an immunosuppressive drug for organ or tissue transplantation at least 3 years before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx;

    Note: organ or tissue transplantation is defined in the Schedule 1 - Dictionary.

13. (13)
    being obese for at least 5 years within the 20 years before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx;

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

14. (14)
    an inability to consume an average of at least 100 grams per day of any combination of fruits and vegetables, for a period of at least 5 consecutive years within the 20 years before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx;
15. (15)
    having periodontitis for at least 5 years within the 20 years before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx;
16. (16)
    for malignant neoplasm of the oral cavity only, having an oral lesion at the affected site, from the specified list of oral lesions, for at least the 1 year before the clinical onset of malignant neoplasm of the oral cavity;

    Note: specified list of oral lesions is defined in the Schedule 1 - Dictionary.

17. (17)
    for malignant neoplasm of the oral cavity only, having an oral lesion caused by systemic lupus erythematosus for at least the 1 year before the clinical onset of malignant neoplasm of the oral cavity;
18. (18)
    inability to obtain appropriate clinical management for malignant neoplasm of the oral cavity, oropharynx or hypopharynx;

Aggravation-only factors: the factors in subsection 9(18) 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.