Soft tissue sarcoma — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 76 of 2023

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 soft tissue sarcoma or death from soft tissue sarcoma with the circumstances of a person's relevant service:

1. (1)
   being: (a) on land in Vietnam; or (b) at sea in Vietnamese waters; or (c) on board a vessel and consuming potable water supplied on that vessel, when the water supply had been produced by evaporative distillation of estuarine Vietnamese waters; for a cumulative period of at least 30 days, at least 5 years before the clinical onset of soft tissue sarcoma;

   Note: being: (i) on land in Vietnam; or (ii) at sea in Vietnamese waters and estuarine Vietnamese waters are defined in the Schedule 1 - Dictionary.

2. (2)
   inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) for a cumulative period of at least 250 hours, at least 2 years before the clinical onset of soft tissue sarcoma;

   Note: inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) is defined in the Schedule 1 - Dictionary.

3. (3)
   undergoing a course of therapeutic radiation for cancer, where the affected region was in the field of radiation, at least 3 years before the clinical onset of soft tissue sarcoma;
4. (4)
   having received a cumulative equivalent dose of at least 0.1 sievert of ionising radiation to the affected region, at least 3 years before the clinical onset of soft tissue sarcoma;

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

5. (5)
   for angiosarcoma only: having received a cumulative equivalent dose of at least 0.1 sievert of ionising radiation to the affected region, at least one year before the clinical onset of soft tissue sarcoma;

   Note: cumulative equivalent dose and angiosarcoma are defined in the Schedule 1 - Dictionary.

6. (6)
   for hepatic angiosarcoma only, having received ionising radiation to the liver from internal deposition of thorium dioxide (Thorotrast), at least 5 years before the clinical onset of soft tissue sarcoma;

   Note: cumulative equivalent dose and angiosarcoma are defined in the Schedule 1 - Dictionary.

7. (7)
   inhaling a cumulative dose of at least 200 ppm-years of gaseous vinyl chloride, at least two years before the clinical onset of soft tissue sarcoma;

   Note: ppm-years is defined in the Schedule 1 - Dictionary.

8. (8)
   for hepatic angiosarcoma only, being exposed to arsenic before the clinical onset of soft tissue sarcoma, where the first exposure to arsenic occurred at least five years before the clinical onset of soft tissue sarcoma;

   Note: being exposed to arsenic and angiosarcoma are defined in the Schedule 1 - Dictionary.

9. (9)
   for uterine sarcoma only, undergoing treatment with tamoxifen for a period of at least 2 months before the clinical onset of soft tissue sarcoma;
10. (10)
    being treated with an immunosuppressive drug resulting in substantial suppression of immune responses: (a) to prevent transplant rejection; (b) to treat malignant cancer; or (c) to treat systemic autoimmune disease; before the clinical onset of soft tissue sarcoma;
11. (11)
    being infected with human immunodeficiency virus before the clinical onset of soft tissue sarcoma;
12. (12)
    for uterine sarcoma only, having diabetes mellitus for at least 5 years before the clinical onset of soft tissue sarcoma;
13. (13)
    for angiosarcoma only, having persistent chronic lymphoedema of the affected region for at least 6 months before the clinical onset of soft tissue sarcoma;

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

14. (14)
    having cutaneous scarring for at least 3 years before the clinical onset of soft tissue sarcoma at that site;
15. (15)
    for cutaneous atypical fibroxanthoma only, having chronic solar skin damage involving the area of skin affected by the cutaneous atypical fibroxanthoma at the time of the clinical onset of soft tissue sarcoma;
16. (16)
    being obese for a period of at least 5 years within the 20 years before the clinical onset of soft tissue sarcoma;

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

17. (17)
    for angiosarcoma only, having an arteriovenous fistula at the site of the angiosarcoma, at least 5 years before the clinical onset of soft tissue sarcoma;

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

18. (18)
    for angiosarcoma only, having a vascular graft at the site of the angiosarcoma, at least 5 years before the clinical onset of soft tissue sarcoma;

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

19. (19)
    for endometrial stromal sarcoma only, having endometriosis before the clinical onset of soft tissue sarcoma, where the soft tissue sarcoma has arisen in close proximity to the endometriosis;
20. (20)
    having chronic osteomyelitis at the affected site at least 15 years before the clinical onset of soft tissue sarcoma;
21. (21)
    inability to obtain appropriate clinical management for soft tissue sarcoma before the clinical worsening of soft tissue sarcoma;

Aggravation-only factors: the factors in subsection 9(21) 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.