Statement of Principles concerning malignant neoplasm of the prostate (Balance of Probabilities) (No. 4 of 2023) (Cth)

Statement of Principles concerning MALIGNANT NEOPLASM OF THE PROSTATE (Balance of Probabilities) (No. 4 of 2023) The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.

Dated 23 December 2022.

The Common Seal of the Repatriation Medical Authority was affixed to this instrument at the direction of:

Professor Terence Campbell AM Chairperson

Contents 1 Name....................................................3 2 Commencement.............................................3 3 Authority..................................................3 4 Repeal...................................................3 5 Application................................................3 6 Definitions................................................3 7 Kind of injury, disease or death to which this Statement of Principles relates.....3 8 Basis for determining the factors..................................4 9 Factors that must exist.........................................4 10 Relationship to service.........................................5 11 Factors referring to an injury or disease covered by another Statement of Principles.5 Schedule 1 - Dictionary...............................................6 1 Definitions................................................6

1 Name This is the Statement of Principles concerning malignant neoplasm of the prostate (Balance of Probabilities) (No. 4 of 2023). 2 Commencement This instrument commences on 23 January 2023. 3 Authority This instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986. 4 Repeal The Statement of Principles concerning malignant neoplasm of the prostate No. 54 of 2014 (Federal Register of Legislation No. F2014L00523) made under subsections 196B(3) and (8) of the VEA is repealed. 5 Application This instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act 2004 applies. 6 Definitions The terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument. 7 Kind of injury, disease or death to which this Statement of Principles relates (1) This Statement of Principles is about malignant neoplasm of the prostate and death from malignant neoplasm of the prostate. Meaning of malignant neoplasm of the prostate (2) For the purposes of this Statement of Principles, malignant neoplasm of the prostate: (a) means a primary malignant neoplasm arising from the epithelial cells of the prostate gland; and (b) includes high grade prostatic intraepithelial neoplasia; and (c) excludes: (i) haematolymphoid tumours (including non-Hodgkin lymphoma and Hodgkin lymphoma); (ii) low grade prostatic intraepithelial neoplasia; (iii) malignant melanoma; (iv) mesenchymal tumours (including soft tissue sarcoma); and (v) primary neuroendocrine tumours. (3) While malignant neoplasm of the prostate attracts ICD‑10‑AM code C61, in applying this Statement of Principles the meaning of malignant neoplasm of the prostate 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. Death from malignant neoplasm of the prostate (5) For the purposes of this Statement of Principles, malignant neoplasm of the prostate, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's malignant neoplasm of the prostate. Note: terminal event is defined in the Schedule 1 – Dictionary. 8 Basis for determining the factors On the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that malignant neoplasm of the prostate and death from malignant neoplasm of the prostate can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA. Note: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary. 9 Factors that must exist At least one of the following factors must exist before it can be said that, on the balance of probabilities, malignant neoplasm of the prostate or death from malignant neoplasm of the prostate is connected with the circumstances of a person's relevant service: (1) being exposed to arsenic as specified before the clinical onset of malignant neoplasm of the prostate, where the first exposure to arsenic occurred at least 10 years before the clinical onset of malignant neoplasm of the prostate; Note: being exposed to arsenic as specified is defined in the Schedule 1 - Dictionary. (2) having smoked tobacco products: (a) in an amount of at least 15 pack-years before the clinical worsening of malignant neoplasm of the prostate; and (b) commencing at least 5 years before the clinical worsening of malignant neoplasm of the prostate; and if smoking has ceased before the clinical worsening of malignant neoplasm of the prostate, then that worsening occurred within 10 years of cessation; Note: one pack-year is defined in the Schedule 1 – Dictionary. (3) being obese for at least 10 years within the 20 years before the clinical worsening of malignant neoplasm of the prostate;