{"id":"F2020L01381","name":"Statement of Principles concerning malignant neoplasm of the cervix (Reasonable Hypothesis) (No. 80 of 2020)","slug":"statement-of-principles-concerning-malignant-neoplasm-of-the-cervix-reasonable-hypothesis-no-80-of-2","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":130597,"registerId":"commonwealth-F2020L01381-current","compilationNumber":null,"startDate":"2026-04-03","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning malignant neoplasm of the cervix (Reasonable Hypothesis) (No. 80 of 2020)","content":"![Commonwealth Coat of Arms](image.001.png)\n\nStatement of Principles concerning malignant neoplasm of the cervix (Reasonable Hypothesis) (No. 80 of 2020)\n\nmade under subsection 196B(2) of the\n\nVeterans' Entitlements Act 1986\n\nCompilation No. 1\n\nCompilation date: 19 September 2022\n\nIncludes amendments up to: Veterans' Entitlements (Statements of Principles—definition of \"one pack-year\") Amendment Determination 2022 (No. 94 of 2022) (F2022L01128)\n\nThe day of commencement of this Amendment Determination is 19 September 2022.\n\nAbout this compilation\n\nThis compilation\n\nThis is a compilation of the Statement of Principles concerning malignant neoplasm of the cervix (Reasonable Hypothesis) (No. 80 of 2020) that shows the text of the law as amended and in force on 19 September 2022.\n\nThe notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.\n\nUncommenced amendments\n\nThe effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.\n\nApplication, saving and transitional provisions for provisions and amendments\n\nIf the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.\n\nModifications\n\nIf the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.\n\nSelf‑repealing provisions\n\nIf a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.\n\nContents\n\n1 Name\n\n3 Authority\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\nEndnotes\n\nEndnote 1—About the endnotes\n\nEndnote 2—Abbreviation key\n\nEndnote 3—Legislation history\n\nEndnote 4—Amendment history\n\n  \n\n1 Name\n\nThis is the Statement of Principles concerning malignant neoplasm of the cervix (Reasonable Hypothesis) (No. 80 of 2020).\n\n3 Authority\n\nThis instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 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 malignant neoplasm of the cervix and death from malignant neoplasm of the cervix.\n\nMeaning of malignant neoplasm of the cervix\n\n(2) For the purposes of this Statement of Principles, malignant neoplasm of the cervix:\n\n(a) means a primary invasive carcinoma, carcinoma in situ, adenocarcinoma in situ or cervical intraepithelial neoplasia grade 3, arising from the cells of the cervix uteri; and\n\n(b) includes squamous cell carcinoma, adenocarcinoma and adenosquamous carcinoma; and\n\n(c) excludes:\n\n(i) cervical intraepithelial neoplasia grades 1 or 2;\n\n(ii) malignant melanoma and melanoma in situ;\n\n(iii) neuroendocrine tumours; and\n\n(iv) soft tissue sarcoma, adenosarcoma, carcinosarcoma,  \nnon-Hodgkin lymphoma and Hodgkin’s lymphoma.\n\n(3) While malignant neoplasm of the cervix attracts ICD‑10‑AM code C53 or D06, in applying this Statement of Principles the meaning of malignant neoplasm of the cervix 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 malignant neoplasm of the cervix\n\n(5) For the purposes of this Statement of Principles, malignant neoplasm of the cervix, 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 cervix.\n\n> Note: terminal event is defined in the Schedule 1 - Dictionary.\n\n8 Basis for determining the factors\n\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that malignant neoplasm of the cervix and death from malignant neoplasm of the cervix can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces under the VEA, or members under the MRCA.\n\n> Note: 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 as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting malignant neoplasm of the cervix or death from malignant neoplasm of the cervix with the circumstances of a person's relevant service:\n\n(1) having a persistent infection of the cervical epithelium with a specified human papillomavirus before the clinical onset of malignant neoplasm of the cervix;\n\n> Note: persistent infection and specified human papillomavirus are defined in the Schedule 1 \\- Dictionary.\n\n(2) having infection with human immunodeficiency virus before the clinical onset of malignant neoplasm of the cervix;\n\n(3) for squamous cell carcinoma of the cervix only, having smoked at least 10 pack-years of tobacco products, at least two years before the clinical onset of squamous cell carcinoma of the cervix, and where smoking has ceased, the clinical onset of squamous cell carcinoma of the cervix has occurred within 20 years of cessation;\n\n> Note: one pack-year is defined in the Schedule 1 - Dictionary.\n\n(4) taking a combined oral contraceptive pill for a continuous period of at least three years, commencing at least five years before the clinical onset of malignant neoplasm of the cervix, and where taking the combined oral contraceptive pill has ceased, the clinical onset of malignant neoplasm of the cervix has occurred within 15 years of cessation;\n\n> Note: combined oral contraceptive pill is defined in the Schedule 1 - Dictionary.\n\n(5) taking an immunosuppressive drug for organ or tissue transplantation at least two years before the clinical onset of malignant neoplasm of the cervix;\n\n> Note: organ or tissue transplantation is defined in the Schedule 1 - Dictionary.\n\n(6) having systemic lupus erythematosus within the five years before the clinical onset of malignant neoplasm of the cervix;\n\n(7) being prevented from accessing clinical screening for cervical precancerous lesions or cervical cancer in accordance with contemporary medical standards of the time, within the seven years before the clinical onset of malignant neoplasm of the cervix, and where:\n\n(a) if clinical screening has subsequently resumed, there has been no normal test result; and\n\n(b) the opportunity for subsequent clinical screening has not been declined;\n\n> Note: cervical precancerous lesions and clinical screening for cervical precancerous lesions or cervical cancer are defined in the Schedule 1 - Dictionary.\n\n(8) being prevented from accessing appropriate treatment for cervical precancerous lesions in accordance with contemporary medical standards of the time, between two and seven years before the clinical onset of malignant neoplasm of the cervix;\n\n> Note: cervical precancerous lesions is defined in the Schedule 1 - Dictionary.\n\n(9) inability to obtain appropriate clinical management for malignant neoplasm of the cervix.\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(9) applies only to material contribution to, or aggravation of, malignant neoplasm of the cervix where the person's malignant neoplasm of the cervix 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(2) 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\nSchedule 1 \\- Dictionary\n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\ncervical precancerous lesions means changes to cervical cells that make them more likely to develop into cancer, and includes cervical intraepithelial neoplasia grades 1 or 2, low grade squamous intraepithelial lesion, mild to moderate dysplasia of the cells of the cervix and atypical glandular cells in the cervix.\n\nclinical screening for precancerous lesions or cervical cancer means human papillomavirus testing or Papanicolaou cytology examinations.\n\ncombined oral contraceptive pill means an oral contraceptive compound containing both estrogen and progestogen.\n\nmalignant neoplasm of the cervix—see subsection 7(2).\n\nMRCA means the Military Rehabilitation and Compensation Act 2004.\n\none 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\n> Note 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\n> Note 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\norgan or tissue transplantation means the transplantation of:\n\n(a) all or part of an organ or tissue; or\n\n(b) a substance obtained from an organ or tissue.\n\npersistent infection means an infection by the same human papillomavirus type for at least two consecutive years.\n\nrelevant service means:\n\n(a) operational service under the VEA;\n\n(b) peacekeeping service under the VEA;\n\n(c) hazardous service under the VEA;\n\n(d) British nuclear test defence service under the VEA;\n\n(e) warlike service under the MRCA; or\n\n(f) non-warlike service under the MRCA.\n\n> Note: MRCA and VEA are also defined in the Schedule 1 - Dictionary.\n\nspecified human papillomavirus means human papillomavirus type 16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 67, 68, 70, 73 or 82.\n\nterminal 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\nVEA means the Veterans' Entitlements Act 1986.\n\n> Note: Endnotes\n\n> Note: Endnote 1—About the endnotes\n\nThe endnotes provide information about this compilation and the compiled law.\n\nThe following endnotes are included in every compilation:\n\nEndnote 1—About the endnotes\n\nEndnote 2—Abbreviation key\n\nEndnote 3—Legislation history\n\nEndnote 4—Amendment history\n\nAbbreviation key—Endnote 2\n\nThe abbreviation key sets out abbreviations that may be used in the endnotes.\n\nLegislation history and amendment history—Endnotes 3 and 4\n\nAmending laws are annotated in the legislation history and amendment history.\n\nThe legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.\n\nThe amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.\n\nMisdescribed amendments\n\nA misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.\n\nIf a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.\n\n> Note: Endnote 2—Abbreviation key\n\n|                                                | o = order(s)                        |\n| ---------------------------------------------- | ----------------------------------- |\n| ad = added or inserted                         | Ord = Ordinance                     |\n| am = amended                                   | orig = original                     |\n| amdt = amendment                               | par = paragraph(s)/subparagraph(s)  |\n| c = clause(s)                                  | /sub‑subparagraph(s)                |\n| C[x] = Compilation No. x                       | pres = present                      |\n| Ch = Chapter(s)                                | prev = previous                     |\n| def = definition(s)                            | (prev…) = previously                |\n| Dict = Dictionary                              | Pt = Part(s)                        |\n| disallowed = disallowed by Parliament          | r = regulation(s)/rule(s)           |\n| Div = Division(s)                              |                                     |\n| exp = expires/expired or ceases/ceased to have | reloc = relocated                   |\n| effect                                         | renum = renumbered                  |\n| F = Federal Register of Legislation            | rep = repealed                      |\n| gaz = gazette                                  | rs = repealed and substituted       |\n| LA = Legislation Act 2003                      | s = section(s)/subsection(s)        |\n| LIA = Legislative Instruments Act 2003         | Sch = Schedule(s)                   |\n| (md) = misdescribed amendment can be given     | Sdiv = Subdivision(s)               |\n| effect                                         | SLI = Select Legislative Instrument |\n| (md not incorp) = misdescribed amendment       | SR = Statutory Rules                |\n| cannot be given effect                         | Sub‑Ch = Sub‑Chapter(s)             |\n| mod = modified/modification                    | SubPt = Subpart(s)                  |\n| No. = Number(s)                                | underlining = whole or part not     |\n|                                                | commenced or to be commenced        |\n\n> Note: Endnote 3—Legislation history\n\n| Name                                                                                                                          | Registration               | Commencement      | Application, saving and transitional provisions |\n| ----------------------------------------------------------------------------------------------------------------------------- | -------------------------- | ----------------- | ----------------------------------------------- |\n| Statement of Principles concerning malignant neoplasm of the cervix (Reasonable Hypothesis) (No. 80 of 2020)                  | 2 November 2020F2020L01381 | 30 November 2020  |                                                 |\n| Veterans' Entitlements (Statements of Principles—definition of \"one pack-year\") Amendment Determination 2022 (No. 94 of 2022) | 26 August 2022F2022L01128  | 19 September 2022 |                                                 |\n\n> Note: Endnote 4—Amendment history\n\n| Provision affected                             | How affected      |\n| ---------------------------------------------- | ----------------- |\n| Section 2……………….                               | rep LA s 48D      |\n| Section 4……………….                               | rep LA s 48C      |\n| Subsection 9(3) note.....                      | rs No. 94 of 2022 |\n| Schedule 1 – Dictionary – one pack-year...…….. | rs No. 94 of 2022 |","sortOrder":0}],"analysis":{"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"},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument remains tightly focused on its original purpose: establishing compensation criteria for cervical cancer in the veteran population. The 2022 amendment (No. 94 of 2022) was a technical update to the definition of \"one pack-year\" to clarify calculation methods, not an expansion of scope. The instrument has not grown beyond its initial medical-legal purpose of connecting specific cervical cancer risk factors to military service eligibility."},"complexity_factors":["Multiple nested conditions in factor (3) — smoking factor applies only to squamous cell carcinoma (not other types), requires specific timing (2 years before onset), and has a cessation window (20 years)","Factor (4) contains three temporal conditions: minimum 3 years continuous use, 5-year lookback from commencement, and 15-year window post-cessation","Factor (7) has dual sub-conditions (7)(a) and (7)(b) regarding screening resumption and non-declining of opportunities","Cross-referencing between the main instrument and Schedule 1 Dictionary for 11 defined terms","Exclusion list in section 7(2)(c) with four specific exclusions from the definition","Dual statutory framework application — operates under both VEA and MRCA with different service definitions","Specific medical terminology requiring ICD-10-AM code cross-reference in section 7(3)-(4)"],"plain_english_summary":"This Statement of Principles sets the medical grounds for Australian defence members, veterans and their families to claim compensation for cervical cancer through the Department of Veterans’ Affairs. By listing specific service‑related risk factors that create a “reasonable hypothesis” of causation, it lowers the proof burden for claimants. It matters because it recognises how service conditions (exposure, disrupted care or limited access to screening/treatment) can contribute to cervical cancer and unlocks entitlement to support."},"flash_summary":{"complexity_score":5,"scope_assessment":{"changed":true,"description":"Amendments recorded in the compilation (Veterans' Entitlements (Statements of Principles—definition of \"one pack‑year\") Amendment Determination 2022 (No. 94 of 2022)) modified the definition and related note to subsection 9(3). That change adjusts how smoking exposure is quantified for the squamous cell carcinoma factor and therefore can change which claims meet the minimum 'reasonable hypothesis' threshold under s9(3) (see Schedule 1 and Endnotes 3–4)."},"complexity_factors":["Multiple, specific temporal windows and exposure thresholds are required (e.g. persistent HPV ≥2 years; smoking quantified in pack‑years with cessation windows; contraceptive and screening/treatment timing) (see s9(1)–(9) and Schedule 1).","Numerous defined terms drive meaning and application (e.g. malignant neoplasm definition with explicit inclusions/exclusions, 'persistent infection', 'specified human papillomavirus', 'one pack‑year') (see s7(2) and Schedule 1).","Interplay with other Statements of Principles: factors that refer to other injuries/diseases import those other SOPs and their terms, creating cross‑instrument dependency (see s11).","Requirement that any factor be related to the person’s relevant service adds a legal connection element separate from the medical facts (see s10(1)–(2)).","Some factors rely on proof of prevention from access to screening or treatment and conditions about subsequent screening/treatment behaviour, which can generate evidentiary and factual inquiries (see s9(7)–(8)).","Authority and evidentiary basis is framed by the Repatriation Medical Authority’s view of 'sound medical‑scientific evidence', indicating administrative judgment underpins the instrument (see s8).","Coding note: ICD‑10‑AM codes are referenced but the statutory text’s definitions prevail, requiring reconciliation between clinical coding and legal definitions (see s7(3)–(4)).","Amendments to measurement rules (notably the definition of 'one pack‑year') alter exposure quantification and require attention to amendment history when applying the smoking factor (see Schedule 1; Endnotes 3–4)."],"plain_english_summary":"This instrument sets the medical criteria that, if proven and connected to a person’s military or peacekeeping service, raise a “reasonable hypothesis” that malignant neoplasm of the cervix (including certain invasive carcinomas and CIN3) or death from it is related to service. It applies to claims under section 120A of the VEA and section 338 of the MRCA and lists specific medical, exposure and screening/treatment‑access factors. Meeting at least one listed factor (and its required timing in relation to clinical onset and service) creates the minimum threshold for further claim assessment."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-cervix-reasonable-hypothesis-no-80-of-2","history":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-cervix-reasonable-hypothesis-no-80-of-2/history","analysis":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-cervix-reasonable-hypothesis-no-80-of-2/analysis","conflicts":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-cervix-reasonable-hypothesis-no-80-of-2/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-cervix-reasonable-hypothesis-no-80-of-2/important-cases","documents":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-cervix-reasonable-hypothesis-no-80-of-2/documents"}}