{"id":"F2021L01915","name":"Statement of Principles concerning colorectal adenoma (Balance of Probabilities) (No. 16 of 2022)","slug":"statement-of-principles-concerning-colorectal-adenoma-balance-of-probabilities-no-16-of-2022","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":441153,"registerId":"F2021L01915-fast-fetch-1775956529191","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning colorectal adenoma (Balance of Probabilities) (No. 16 of 2022)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\nmeta-generator: Aspose.Words for .NET 20.2\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n\n\n \n\nStatement of Principles\n\nconcerning\n\nCOLORECTAL ADENOMA (Balance of Probabilities)\n\n(No. 16 of 2022)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n \n\nDated 24 December 2021\n\n \n\n \n\n \n\n \n\n \n\n| The Common Seal of the Repatriation Medical Authority was affixed to this instrument at the direction of:
|\n| --- |\n|
Professor Terence Campbell AM
Chairperson
|\n\n\n \n\n \n\n\nContents\n\n1 Name\n\n2 Commencement\n\n3 Authority\n\n4 Repeal\n\n5 Application\n\n6 Definitions\n\n7 Kind of injury, disease or death to which this Statement of Principles relates\n\n8 Basis for determining the factors\n\n9 Factors that must exist\n\n10 Relationship to service\n\n11 Factors referring to an injury or disease covered by another Statement of Principles\n\nSchedule 1 - Dictionary\n\n1 Definitions\n\n \n\n\n\n\n1 Name\n\nThis is the Statement of Principles concerning colorectal adenoma (Balance of Probabilities) (No. 16 of 2022).\n\n2 Commencement\n\n This instrument commences on 31 January 2022.\n\n3 Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning colorectal adenoma No. 36 of 2013 (Federal Register of Legislation No. F2013L01141) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act 2004 applies.\n\n6 Definitions\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n7 Kind of injury, disease or death to which this Statement of Principles relates\n\n(1) This Statement of Principles is about colorectal adenoma and death from colorectal adenoma.\n\nMeaning of colorectal adenoma\n\n(2) For the purposes of this Statement of Principles, colorectal adenoma:\n\n(a) means a benign neoplasm arising from the epithelial cells of the colorectum; and\n\n(b) includes:\n\n(i) adenomatous polyp;\n\n(ii) sessile serrated adenoma; and\n\n(iii) traditional serrated adenoma; and\n\n(c) excludes:\n\n(i) benign neoplasms of the anus and anal canal;\n\n(ii) familial adenomatous polyposis;\n\n(iii) non-neoplastic polyps of the colon;\n\n(iv) nonepithelial neoplasms of the colon; and\n\n(v) non-polypoid dysplasia.\n\n(3) While colorectal adenoma attracts ICD‑10‑AM code D12.0, D12.1, D12.2, D12.3, D12.4, D12.5, D12.7 or D12.8, in applying this Statement of Principles the meaning of colorectal adenoma is that given in subsection (2).\n\n(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.\n\nDeath from colorectal adenoma\n\n(5) For the purposes of this Statement of Principles, colorectal adenoma, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's colorectal adenoma.\n\nNote: terminal event is defined in the Schedule 1 - Dictionary.\n\n8 Basis for determining the factors\n\nOn the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that colorectal adenoma and death from colorectal adenoma can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA.\n\nNote: MRCA, relevant service and VEA are defined in the Schedule 1 - Dictionary.\n\n9 Factors that must exist\n\nAt least one of the following factors must exist before it can be said that, on the balance of probabilities, colorectal adenoma or death from colorectal adenoma is connected with the circumstances of a person's relevant service:\n\n(1) having smoked tobacco products:\n\n(a) in an amount of at least 20 pack-years before the clinical onset of colorectal adenoma; and\n\n(b) commencing at least 5 years before the clinical onset of colorectal adenoma; and\n\nif smoking has ceased before the clinical onset of colorectal adenoma, then that onset occurred within 15 years of cessation;\n\nNote: one pack-year is defined in the Schedule 1 - Dictionary.\n\n(2) consuming at least 500 kilograms of alcohol before the clinical onset of colorectal adenoma;\n\nNote: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.\n\n(3) being obese for at least 10 years within the 30 years before the clinical onset of colorectal adenoma;\n\nNote: being obese is defined in the Schedule 1 - Dictionary.\n\n(4) having diabetes mellitus for at least 5 years before the clinical onset of colorectal adenoma;\n\n(5) inability to consume an average of at least 20 grams per day of fibre in food, for at least 5 consecutive years within the 10 years before the clinical onset of colorectal adenoma;\n\nNote: fibre in food is defined in the Schedule 1 - Dictionary.\n\n(6) for adenoma of the colon only:\n\n(a) inability to undertake any physical activity greater than 3 METs for at least 10 consecutive years within the 30 years before the clinical onset of adenoma of the colon;\n\nNote: adenoma of the colon and MET are defined in the Schedule 1 - Dictionary.\n\n(b) consuming an average of at least 100 grams per day of red meat, for at least 5 years within the 10 years before the clinical onset of adenoma of the colon;\n\nNote: adenoma of the colon and red meat are defined in the Schedule 1 - Dictionary.\n\n(c) consuming an average of at least 25 grams per day of processed meat product, for at least 5 years within the 10 years before the clinical onset of adenoma of the colon;\n\nNote: adenoma of the colon and processed meat product are defined in the Schedule 1 - Dictionary.\n\n(7) inability to obtain appropriate clinical management for colorectal adenoma.\n\n10 Relationship to service\n\n(1) The existence in a person of any factor referred to in section 9, must be related to the relevant service rendered by the person.\n\n(2) The factor set out in subsection 9(7) applies only to material contribution to, or aggravation of, colorectal adenoma where the person's colorectal adenoma was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n\n11 Factors referring to an injury or disease covered by another Statement of Principles\n\nIn this Statement of Principles:\n\n(1) if a factor referred to in section 9 applies in relation to a person; and\n\n(2) that factor refers to an injury or disease in respect of which a Statement of Principles has been determined under subsection 196B(3) of the VEA;\n\nthen the factors in that Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.\n\n \n\n \n\nSchedule 1 - Dictionary \n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\n adenoma of the colon means a benign epithelial neoplasm of the colon. Anatomically the colon is defined as extending from the caecum, including the ileocaecal junction and the vermiform appendix, to the sigmoid colon, not including the rectosigmoid junction.\n\n being obese means:\n\n(a) having a Body Mass Index (BMI) of 30 or greater; or\n\n(b) for males, having a waist circumference exceeding 102 centimetres; or\n\n(c) for females, having a waist circumference exceeding 88 centimetres.\n\nNote: BMI is also defined in the Schedule 1 - Dictionary.\n\n BMI means W/H2 where:\n\n(a) W is the person's weight in kilograms; and\n\n(b) H is the person's height in metres.\n\n colorectal adenoma—see subsection 7(2).\n\n fibre in food means complex carbohydrates of plant origin consumed as vegetables, fruits or cereals which resist digestion by gastrointestinal enzymes in the gastrointestinal tract, and include plant cell walls and non-starch polysaccharides from sources other than cell walls, including cellulose and pectins.\n\n MET means a unit of measurement of the level of physical exertion. 1 MET = 3.5 ml of oxygen/kg of body weight per minute, or 1.0 kcal/kg of body weight per hour, or resting metabolic rate.\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n one pack-year means the amount of tobacco consumed in smoking 20 cigarettes per day for a period of 1 year, or an equivalent amount of tobacco products.\n\nNote 1: An equivalent amount of tobacco products is 7,300 grams of smoking tobacco by weight, either in cigarettes, pipe tobacco or cigars, or a combination of same. For pipe tobacco, cigars or combinations of multiple tobacco types, 1 gram of tobacco is considered to be equal to one cigarette.\n\nNote 2: Pack-years are calculated by dividing the number of cigarettes smoked per day by 20 and multiplying this number by the number of years the person has smoked. For example, smoking 10 cigarettes per day for 10 years is equal to 5 pack-years, and smoking 40 cigarettes per day for 10 years is equal to 20 pack-years.\n\n processed meat product means preserved or cured meats, including ham, frankfurters, salami and bacon.\n\n red meat means all types of mammalian meat, including beef, veal, pork, lamb, mutton, horse and goat.\n\n relevant service means:\n\n(a) eligible war service (other than operational service) under the VEA;\n\n(b) defence service (other than hazardous service and British nuclear test defence service) under the VEA; or\n\n(c) peacetime service under the MRCA.\n\nNote: MRCA and VEA are also defined in the Schedule 1 - Dictionary.\n\n terminal event means the proximate or ultimate cause of death and includes the following:\n\n(a) pneumonia;\n\n(b) respiratory failure;\n\n(c) cardiac arrest;\n\n(d) circulatory failure; or\n\n(e) cessation of brain function.\n\n VEA means the Veterans' Entitlements Act 1986.\n\n \n\n \n","sortOrder":0}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This is a standard replacement Statement of Principles under the Veterans' Entitlements Act 1986. It maintains the same scope as its 2013 predecessor—establishing medical criteria for linking colorectal adenoma to military service. The update reflects new medical evidence but does not expand beyond the original purpose of determining service connection for this specific condition."},"complexity_factors":["Multiple nested time-based conditions (e.g., 'at least 10 years within the 30 years before clinical onset')","Mathematical calculations required for pack-years, BMI, and alcohol consumption thresholds","Specific anatomical exclusions and inclusions in the definition of colorectal adenoma (subsection 7(2))","Conditional logic for factor 9(7) which only applies to aggravation cases, not initial causation","Cross-referencing between the main instrument and Schedule 1 Dictionary for 12 defined terms","Dual legislative framework application (VEA and MRCA with different service definitions)","ICD-10-AM coding references with specific edition and ISBN citation"],"plain_english_summary":"This instrument updates the 2013 medical rules for deciding veterans’ compensation claims for colorectal adenoma (and related deaths) under the VEA and MRCA. It requires claimants to show, on the balance of probabilities, that at least one specified risk factor was present and connected to service; precise numerical thresholds and time windows set clear but strict eligibility limits."},"flash_summary":{"complexity_score":6,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2013 Statement of Principles and replaces it with a newly specified set of linking criteria. The application remains to claims under VEA s120B and MRCA s339, but the substantive scope is reset by the updated thresholds, definitions and exclusions contained in this instrument."},"complexity_factors":["Multiple numeric exposure thresholds (e.g. pack‑years, 500 kg alcohol, grams/day meat) requiring quantification of past behaviour.","Temporal qualifications and windows (e.g. durations of exposure, minimum latency, cessation cut‑offs).","Differentiated criteria for colon adenoma versus other colorectal sites.","Detailed dictionary definitions (BMI, MET, fibre, pack‑year equivalence, ICD‑10‑AM codes) that must be applied consistently.","Interaction and cross‑reference with other Statements of Principles where factors overlap.","Requirement that listed factors be related to the person’s relevant service for entitlement (causal link assessment).","Burden of proof standard is balance of probabilities, but relies on reconstructing historical exposures which raises evidentiary complexity.","Repeal and replacement of a prior instrument—administrative transition and interpretation issues for existing claims."],"plain_english_summary":"This Statement of Principles sets out the medical criteria used to decide whether colorectal adenoma (benign colon/rectal polyps) is related to a veteran's or service member's relevant service for VEA and MRCA claims. It repeals the 2013 instrument and commenced on 31 January 2022.\n\nIt specifies measurable risk‑factor thresholds (smoking, alcohol, obesity, diabetes, low dietary fibre, physical inactivity, red/processed meat intake, and inadequate clinical management) which, if linked to a person’s service, support a finding of service connection on the balance of probabilities and affect entitlement assessments."},"flash_summary_failed":{"failed":true,"reason":"Unauthenticated. Configure AI_GATEWAY_API_KEY or use a provider module. Learn more: https://ai-sdk.dev/unauthenticated-ai-gateway","source":"analysis-cron"}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-colorectal-adenoma-balance-of-probabilities-no-16-of-2022","history":"/api/acts/statement-of-principles-concerning-colorectal-adenoma-balance-of-probabilities-no-16-of-2022/history","analysis":"/api/acts/statement-of-principles-concerning-colorectal-adenoma-balance-of-probabilities-no-16-of-2022/analysis","conflicts":"/api/acts/statement-of-principles-concerning-colorectal-adenoma-balance-of-probabilities-no-16-of-2022/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-colorectal-adenoma-balance-of-probabilities-no-16-of-2022/important-cases","documents":"/api/acts/statement-of-principles-concerning-colorectal-adenoma-balance-of-probabilities-no-16-of-2022/documents"}}