SoP LibraryMalignant neoplasm of the renal pelvis and ureter

Statement of Principles

Malignant neoplasm of the renal pelvis and ureter — DVA SoP factors

Every factor in the Repatriation Medical Authority Statements of Principles for Malignant neoplasm of the renal pelvis and ureter. DVA can only accept a claim for Malignant neoplasm of the renal pelvis and ureter if at least one of these factors is met and connected to your service. Reasonable Hypothesis (RH) applies to operational service; Balance of Probabilities (BoP) applies to peacetime service.

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.

Malignant neoplasm of the renal pelvis and ureter

RH No. 92 of 2019 · BoP No. 93 of 201943 factors

Meaning of malignant neoplasm of the renal pelvis and ureter: For the purposes of this Statement of Principles, malignant neoplasm of the renal pelvis and ureter: (a) means a primary malignant neoplasm arising from the epithelial cells of the upper urinary tract, including the renal calyces, renal pelvis, pelviureteric junction and ureter, but excluding the ureteric orifice of the bladder; and (b) includes urothelial carcinoma (also known as transitional cell carcinoma), squamous cell carcinoma, adenocarcinoma, small cell carcinoma and carcinoma in situ; and (c) excludes soft tissue sarcoma, carcinoid tumour, non-Hodgkin lymphoma and Hodgkin's lymphoma. (3) While malignant neoplasm of the renal pelvis and ureter attracts ICD-10-AM code C65 or C66, in applying this Statement of Principles the meaning of malignant neoplasm of the renal pelvis and ureter 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 Pr

Reasonable Hypothesis (RH) — Statement of Principles No. 92 of 2019

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 renal pelvis and ureter or death from malignant neoplasm of the renal pelvis and ureter with the circumstances of a person's relevant service:

  1. (1)
    smoking at least 2.5 pack-years of cigarettes, or the equivalent thereof in other tobacco products, before the clinical onset of malignant neoplasm of the renal pelvis or ureter, where smoking commenced at least five years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

    Note: pack-years of cigarettes, or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary.

  2. (2)
    having received a cumulative equivalent dose of at least 0.1 sievert of ionising radiation to the affected site at least five years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

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

  3. (3)
    inhaling, ingesting or having cutaneous contact with high concentrations of polycyclic aromatic hydrocarbons, through work involving a specified industrial or manufacturing process 1: (a) for a cumulative period of at least 1 500 hours, before the clinical onset of malignant neoplasm of the renal pelvis or ureter; and (b) where the first exposure occurred at least five years before the clinical onset of malignant neoplasm of renal pelvis or ureter;

    Note: polycyclic aromatic hydrocarbons and specified industrial or manufacturing process 1 are defined in the Schedule 1 - Dictionary.

  4. (4)
    inhaling, ingesting or having cutaneous contact with an agent from the specified list of agents containing high concentrations of polycyclic aromatic hydrocarbons: (a) for a cumulative period of at least 1 500 hours, before the clinical onset of malignant neoplasm of the renal pelvis or ureter; and (b) where the first exposure occurred at least five years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

    Note: specified list of agents containing high concentrations of polycyclic aromatic hydrocarbons is defined in the Schedule 1 - Dictionary.

  5. (5)
    inhaling, ingesting or having cutaneous contact with an aromatic amine from the specified list of aromatic amines: (a) for a cumulative period of at least 1 000 hours, before the clinical onset of malignant neoplasm of the renal pelvis or ureter; and (b) where the first exposure occurred at least five years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

    Note: Inhaling, ingesting or having cutaneous contact with an aromatic amine does not include exposure due to cigarette smoke or hair dyes.

    Note: specified list of aromatic amines is defined in the Schedule 1 - Dictionary.

  6. (6)
    inhaling, ingesting or having cutaneous contact with a high concentration of an aromatic amine, through work involving the specified industrial or manufacturing process 2: (a) for a cumulative period of at least 1 500 hours, before the clinical onset of malignant neoplasm of the renal pelvis or ureter; and (b) where the first exposure occurred at least five years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

    Note: Inhaling, ingesting or having cutaneous contact with a high concentration of an aromatic amine does not include exposure due to cigarette smoke or hair dyes.

    Note: specified industrial or manufacturing process 2 is defined in the Schedule 1 - Dictionary.

  7. (7)
    inhaling, ingesting or having cutaneous contact with tetrachloroethylene for a cumulative period of at least 5 000 hours, before the clinical onset of malignant neoplasm of the renal pelvis or ureter, where the first exposure occurred at least five years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;
  8. (8)
    being heavily exposed to diesel engine exhaust for a cumulative period of at least 15 000 hours, before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

    Note: being heavily exposed to diesel engine exhaust is defined in the Schedule 1 - Dictionary.

  9. (9)
    being exposed to lead as specified before the clinical onset of malignant neoplasm of the renal pelvis or ureter, where the first exposure to lead occurred at least five years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

    Note: being exposed to lead as specified is defined in the Schedule 1 - Dictionary.

  10. (10)
    being exposed to arsenic as specified before the clinical onset of malignant neoplasm of the renal pelvis or ureter, where the first exposure to arsenic occurred at least ten years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

    Note: being exposed to arsenic as specified is defined in the Schedule 1 - Dictionary.

  11. (11)
    working as a painter for a cumulative period of at least 5 000 hours, before the clinical onset of malignant neoplasm of the renal pelvis or ureter, where that work began at least five years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

    Note: working as a painter is defined in the Schedule 1 - Dictionary.

  12. (12)
    working as a hairdresser or barber for a cumulative period of at least 5 000 hours, before the clinical onset of malignant neoplasm of the renal pelvis or ureter, where that work began at least five years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

    Note: working as a hairdresser or barber is defined in the Schedule 1 - Dictionary.

  13. (13)
    having renal stone disease of the affected urinary tract at least five years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;
  14. (14)
    having hydronephrosis or hydroureter of the affected urinary tract at least five years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;
  15. (15)
    having chronic renal failure at least one year before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

    Note: chronic renal failure is defined in the Schedule 1 - Dictionary.

  16. (16)
    ingesting aristolochic acid as specified at least two years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

    Note: ingesting aristolochic acid as specified is defined in the Schedule 1 - Dictionary.

  17. (17)
    consuming a total of at least 50 grams of phenacetin at least five years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

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

  18. (18)
    being treated with systemic cyclophosphamide or systemic ifosfamide, at least five years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;
  19. (19)
    being treated with chlornaphazine at least five years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;
  20. (20)
    being treated with pioglitazone, or a medication containing pioglitazone, for a continuous period of at least one year, within the ten years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;
  21. (21)
    having diabetes mellitus for at least five years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;
  22. (22)
    having an infection of the renal pelvis or ureter with Schistosoma haematobium at least five years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;
  23. (23)
    having an indwelling ureteric stent or other foreign body in the ureter for a continuous period (excepting routine stent changes) of at least five years, before the clinical onset of malignant neoplasm of the renal pelvis or ureter;
  24. (24)
    having neurogenic bladder at least five years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

    Note: neurogenic bladder is defined in the Schedule 1 - Dictionary.

  25. (25)
    having chronic urinary tract infection at least five years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

    Note: chronic urinary tract infection is defined in the Schedule 1 - Dictionary.

  26. (26)
    inability to obtain appropriate clinical management for malignant neoplasm of the renal pelvis and ureter;

Aggravation-only factors: the factors in subsection 9(26) 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. 93 of 2019

17 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 renal pelvis and ureter or death from malignant neoplasm of the renal pelvis and ureter is connected with the circumstances of a person's relevant service:

  1. (1)
    smoking at least five pack-years of cigarettes, or the equivalent thereof in other tobacco products, before the clinical onset of malignant neoplasm of the renal pelvis or ureter, where smoking commenced at least ten years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

    Note: pack-years of cigarettes, or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary.

  2. (2)
    having received a cumulative equivalent dose of at least 0.5 sievert of ionising radiation to the affected site at least ten years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

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

  3. (3)
    inhaling, ingesting or having cutaneous contact with high concentrations of polycyclic aromatic hydrocarbons, through work involving a specified industrial or manufacturing process 1: (a) for a cumulative period of at least 3 500 hours, before the clinical onset of malignant neoplasm of the renal pelvis or ureter; and (b) where the first exposure occurred at least ten years before the clinical onset of malignant neoplasm of renal pelvis or ureter;

    Note: polycyclic aromatic hydrocarbons and specified industrial or manufacturing process 1 are defined in the Schedule 1 - Dictionary.

  4. (4)
    inhaling, ingesting or having cutaneous contact with an agent from the specified list of agents containing high concentrations of polycyclic aromatic hydrocarbons: (a) for a cumulative period of at least 3 500 hours, before the clinical onset of malignant neoplasm of the renal pelvis or ureter; and (b) where the first exposure occurred at least ten years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

    Note: specified list of agents containing high concentrations of polycyclic aromatic hydrocarbons is defined in the Schedule 1 - Dictionary.

  5. (5)
    inhaling, ingesting or having cutaneous contact with an aromatic amine from the specified list of aromatic amines: (a) for a cumulative period of at least 2 000 hours, before the clinical onset of malignant neoplasm of the renal pelvis or ureter; and (b) where the first exposure occurred at least ten years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

    Note: Inhaling, ingesting or having cutaneous contact with an aromatic amine does not include exposure due to cigarette smoke or hair dyes.

    Note: specified list of aromatic amines is defined in the Schedule 1 - Dictionary.

  6. (6)
    inhaling, ingesting or having cutaneous contact with a high concentration of an aromatic amine, through work involving the specified industrial or manufacturing process 2: (a) for a cumulative period of at least 3 500 hours, before the clinical onset of malignant neoplasm of the renal pelvis or ureter; and (b) where the first exposure occurred at least ten years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

    Note: Inhaling, ingesting or having cutaneous contact with a high concentration of an aromatic amine does not include exposure due to cigarette smoke or hair dyes.

    Note: specified industrial or manufacturing process 2 is defined in the Schedule 1 - Dictionary.

  7. (7)
    inhaling, ingesting or having cutaneous contact with tetrachloroethylene for a cumulative period of at least 10 000 hours, before the clinical onset of malignant neoplasm of the renal pelvis or ureter, where the first exposure occurred at least ten years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;
  8. (8)
    being exposed to arsenic as specified before the clinical onset of malignant neoplasm of the renal pelvis or ureter, where the first exposure to arsenic occurred at least ten years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

    Note: being exposed to arsenic as specified is defined in the Schedule 1 - Dictionary.

  9. (9)
    working as a painter for a cumulative period of at least 10 000 hours, before the clinical onset of malignant neoplasm of the renal pelvis or ureter, where that work began at least ten years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

    Note: working as a painter is defined in the Schedule 1 - Dictionary.

  10. (10)
    having renal stone disease of the affected urinary tract at least ten years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;
  11. (11)
    having hydronephrosis or hydroureter of the affected urinary tract at least ten years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;
  12. (12)
    having chronic renal failure at least one year before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

    Note: chronic renal failure is defined in the Schedule 1 - Dictionary.

  13. (13)
    ingesting aristolochic acid as specified at least four years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

    Note: ingesting aristolochic acid as specified is defined in the Schedule 1 - Dictionary.

  14. (14)
    consuming a total of at least 100 grams of phenacetin at least five years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;

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

  15. (15)
    being treated with systemic cyclophosphamide or systemic ifosfamide, at least five years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;
  16. (16)
    being treated with chlornaphazine at least five years before the clinical onset of malignant neoplasm of the renal pelvis or ureter;
  17. (17)
    inability to obtain appropriate clinical management for malignant neoplasm of the renal pelvis and ureter;

Aggravation-only factors: the factors in subsection 9(17) 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.

A VHC Diagnostic Assessment addresses each of these factors one by one against your service record and clinical history. See how a VHC DVA claim works, see all fees ($600 + GST per stage) or book an appointment.

About Dr Thomas Perkins

One doctor. Every report.

Founding doctor of the Veterans Health Centre in Ipswich, Queensland, and one of Australia's most experienced practitioners in veterans' medicolegal medicine.

Dr Perkins has spent more than thirteen years working exclusively with current and former ADF members — treating their conditions, writing their reports and navigating the DVA system alongside them. With over 100,000 claims submitted and 2,000 Permanent Impairment Assessments completed, he has seen precisely what separates an accepted claim from a rejected one at every level, from initial liability to the Veterans' Review Board.

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