{"id":"F2021L01401","name":"Statement of Principles concerning malignant neoplasm of the pancreas (Reasonable Hypothesis) (No. 103 of 2021)","slug":"statement-of-principles-concerning-malignant-neoplasm-of-the-pancreas-reasonable-hypothesis-no-103-o","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":441033,"registerId":"F2021L01401-fast-fetch-1775956462630","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning malignant neoplasm of the pancreas (Reasonable Hypothesis) (No. 103 of 2021)","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\nMALIGNANT NEOPLASM OF THE PANCREAS (Reasonable Hypothesis)\n\n(No. 103 of 2021)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n \n\nDated 1 October 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:
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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 malignant neoplasm of the pancreas (Reasonable Hypothesis) (No. 103 of 2021).\n\n2 Commencement\n\n This instrument commences on 1 November 2021.\n\n3 Authority\n\nThis instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning malignant neoplasm of the pancreas No. 73 of 2013 (Federal Register of Legislation No. F2013L01891) made under subsections 196B(2) and (8) of the VEA is repealed.\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 pancreas and death from malignant neoplasm of the pancreas.\n\nMeaning of malignant neoplasm of the pancreas\n\n(2) For the purposes of this Statement of Principles, malignant neoplasm of the pancreas:\n\n(a) means a primary malignant neoplasm arising from the cells of the exocrine pancreas; and\n\n(b) excludes soft tissue sarcoma, carcinoid tumour, endocrine tumours, non-Hodgkin lymphoma and Hodgkin's lymphoma.\n\n(3) While malignant neoplasm of the pancreas attracts ICD‑10‑AM code C25.0, C25.1, C25.2, C25.3, C25.7 or C25.8, in applying this Statement of Principles the meaning of malignant neoplasm of the pancreas 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 pancreas\n\n(5) For the purposes of this Statement of Principles, malignant neoplasm of the pancreas, 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 pancreas.\n\nNote: 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 pancreas and death from malignant neoplasm of the pancreas 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\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 as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting malignant neoplasm of the pancreas or death from malignant neoplasm of the pancreas 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 10 pack-years before the clinical onset of malignant neoplasm of the pancreas; and\n\n(b) commencing at least 5 years before the clinical onset of malignant neoplasm of the pancreas; and\n\nif smoking has ceased before the clinical onset of malignant neoplasm of the pancreas, then that onset occurred within 20 years of cessation;\n\nNote: one pack-year is defined in the Schedule 1 - Dictionary. \n\n(2) the oral use of smokeless tobacco:\n\n(a) on more days than not; and\n\n(b) for at least 20 years before the clinical onset of malignant neoplasm of the pancreas; and\n\nif the oral use of smokeless tobacco has ceased before the clinical onset of malignant neoplasm of the pancreas, then that onset occurred within 20 years of cessation;\n\nNote: smokeless tobacco is defined in the Schedule 1 - Dictionary. \n\n(3) being overweight or obese for at least 5 years within the 30 years before the clinical onset of malignant neoplasm of the pancreas;\n\nNote: being overweight or obese is defined in the Schedule 1 - Dictionary. \n\n(4) having diabetes mellitus for at least 5 years before the clinical onset of malignant neoplasm of the pancreas;\n\n(5) having chronic pancreatitis for at least 2 years before the clinical onset of malignant neoplasm of the pancreas;\n\n(6) having acute pancreatitis at least 2 years before the clinical onset of malignant neoplasm of the pancreas;\n\n(7) inhaling, ingesting or having cutaneous contact with DDT:\n\n(a) for a cumulative period of at least 1,000 hours before the clinical onset of malignant neoplasm of the pancreas; and\n\n(b) where the first exposure occurred at least 5 years before the clinical onset of malignant neoplasm of the pancreas;\n\nNote: DDT and inhaling, ingesting or having cutaneous contact with DDT are defined in the Schedule 1 - Dictionary. \n\n(8) undergoing a partial gastrectomy at least 20 years before the clinical onset of malignant neoplasm of the pancreas;\n\n(9) having received ionising radiation to the pancreas, from internal deposition of a therapeutic or diagnostic substance which emits alpha particles, at least 5 years before the clinical onset of malignant neoplasm of the pancreas;\n\nNote: An example of a therapeutic or diagnostic substance which emits alpha particles is thorium dioxide which is the main component of the radiocontrast agent Thorotrast, used during the 1930s - 1950s. \n\n(10) having cholelithiasis or having undergone a cholecystectomy at least 2 years before the clinical onset of malignant neoplasm of the pancreas;\n\n(11) having infection with hepatitis B virus before the clinical onset of malignant neoplasm of the pancreas;\n\n(12) having infection with hepatitis C virus before the clinical onset of malignant neoplasm of the pancreas;\n\n(13) inability to obtain appropriate clinical management for malignant neoplasm of the pancreas.\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(13) applies only to material contribution to, or aggravation of, malignant neoplasm of the pancreas where the person's malignant neoplasm of the pancreas 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\n \n\n \n\nSchedule 1 - Dictionary \n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\n being overweight or obese means:\n\n(a) having a Body Mass Index (BMI) of 25 or greater; or\n\n(b) for males, having a waist circumference exceeding 94 centimetres; or\n\n(c) for females, having a waist circumference exceeding 80 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 DDT means a complex synthetic mixture in which para,para'-dichlorodiphenyltrichloroethane predominates.\n\n inhaling, ingesting or having cutaneous contact with DDT means:\n\n(a) being involved in the manufacture of DDT; or\n\n(b) being sprayed with DDT; or\n\n(c) cleaning or maintaining equipment used to apply DDT; or\n\n(d) decanting or spraying DDT; or\n\n(e) wearing or handling clothes treated or contaminated with DDT.\n\nNote: DDT is also defined in the Schedule 1 - Dictionary.\n\n malignant neoplasm of the pancreas—see subsection 7(2).\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 one 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 relevant 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\nNote: MRCA and VEA are also defined in the Schedule 1 - Dictionary.\n\n smokeless tobacco means tobacco products without combustion or pyrolysis at the time of use, including chewing tobacco and tobacco snuff.\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":{"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument maintains the established scope of Repatriation Medical Authority Statements of Principles. It updates the 2013 version with current medical evidence but does not expand beyond the traditional function of listing service-connectable risk factors for a specific condition under the reasonable hypothesis standard. The structure, definitional approach, and relationship to the VEA/MRCA framework remain consistent with longstanding RMA practice."},"complexity_factors":["13 distinct factors with multiple sub-conditions (temporal requirements, cumulative thresholds, cessation clauses)","Nested definitions requiring cross-reference to Schedule 1 (e.g., 'being overweight or obese' defined via BMI formula and waist circumference thresholds)","Mathematical calculations required for pack-years and BMI","Temporal logic chains: multiple factors require specific time gaps between exposure and onset (5 years, 20 years, 2 years, 30-year lookback windows)","Conditional cessation clauses: factors (1) and (2) include 'if ceased, then within 20 years' logic","Cross-referencing mechanism in section 11 allowing incorporation of other Statements of Principles by reference","Exclusionary definitions in section 7(2) specifying what does NOT count as pancreatic cancer under this instrument","Dual statutory framework application (VEA and MRCA) with defined service types in the Dictionary"],"plain_english_summary":"This instrument sets medical rules for when veterans and ADF members can claim pancreatic cancer under the \"reasonable hypothesis\" test. It identifies 13 service‑linked risk factors (e.g., significant smoking history, obesity/diabetes, chronic pancreatitis, DDT or certain radiation exposures) that, if connected to service, allow claims to succeed without definitive proof of causation.\n\nIt replaces the 2013 rules and eases the evidentiary burden for veterans covered by the VEA or MRCA."},"flash_summary":{"complexity_score":5,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the earlier Statement of Principles concerning malignant neoplasm of the pancreas (No. 73 of 2013) (section 4) and comes into force 1 November 2021 (section 2). It therefore replaces the prior SOP and establishes the operative factors, definitions and application rules for claims under VEA s120A or MRCA s338 (section 5). The text itself does not itemise differences from the repealed instrument, only that the prior SOP is revoked and superseded."},"complexity_factors":["Multiple discrete qualifying factors with different quantitative and temporal thresholds (e.g. smoking: ≥10 pack‑years, start ≥5 years before onset, cessation window 20 years) — see section 9(1) and Schedule 1 (one pack‑year).","Exposure definitions with cumulative-hour requirements (DDT: ≥1,000 cumulative hours and first exposure ≥5 years before onset) — see section 9(7) and Schedule 1 (DDT, inhaling/ingesting/contact).","Medical-condition thresholds with varying required durations (e.g. diabetes mellitus ≥5 years, chronic pancreatitis ≥2 years, partial gastrectomy ≥20 years) — see section 9(3)–(6) and (8).","Specific radiation exposure pathway limited to internal alpha‑emitting agents (e.g. Thorotrast) with ≥5 year latency — see section 9(9).","Cross‑references to other Statements of Principles where a listed factor is itself an injury/disease with its own SOP — see section 11.","Strict definitions for clinical concepts and measurements (BMI formula, waist circumference cutoffs, smokeless tobacco, terminal event) that determine eligibility — see Schedule 1.","Application tied to statutory claims frameworks (VEA s120A / MRCA s338) and repeal of a prior SOP — see sections 2, 4 and 5, which affects which claim streams use these criteria.","Requirement that any listed factor be related to the person's relevant service, and a narrower operation for factor 9(13) (lack of appropriate clinical management) — see section 10(1)–(2), introducing legal causation and material contribution rules.","Exclusions of several tumour types from the definition of malignant neoplasm of the pancreas, and reliance on ICD‑10‑AM codes only for reference — see section 7(2)–(4).","Administrative and evidentiary burden implied by the need to establish timing, duration and exposure details from medical and service records (sections 9 and 10; Schedule 1 definitions)."],"plain_english_summary":"This Statement of Principles sets the medical criteria for deciding when malignant neoplasm of the pancreas (pancreatic cancer) — or death from it — can be reasonably linked to a person’s Australian defence service. It lists specific exposures, medical conditions, quantitative thresholds and timing rules claimants must meet. \n\nIt affects veterans and eligible members lodging claims under the VEA or the MRCA by defining which risk factors and service‑related exposures can be treated as connected to the disease, and so shape entitlement decisions."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-pancreas-reasonable-hypothesis-no-103-o","history":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-pancreas-reasonable-hypothesis-no-103-o/history","analysis":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-pancreas-reasonable-hypothesis-no-103-o/analysis","conflicts":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-pancreas-reasonable-hypothesis-no-103-o/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-pancreas-reasonable-hypothesis-no-103-o/important-cases","documents":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-pancreas-reasonable-hypothesis-no-103-o/documents"}}