Reasonable Hypothesis SOP [1] | 74 of 2023 |
Balance of Probabilities SOP [2] | 75 of 2023 |
SOP Bulletin 237 [3]
ICD-10-AM Code: C16
Gastric cancer is one of the most common cancers worldwide, though is less common in Western countries. There are a number of sub-types of the disease with the most common being adenocarcinoma. This SOP covers primary epithelial cancers of the cardia, body, antrum and pyloris of the stomach.
Histology (from biopsy, an excised specimen, or autopsy) is required to confirm the diagnosis and apply the SOP. Information on whether the primary site is the cardia of the stomach (near the oesophagus), or the rest of the stomach, will be needed to apply some of the SOP factors.
The relevant medical specialist is an oncologist, general surgeon, or gastroenterologist.
* another SOP applies
# non-SOP condition
The condition typically presents at a late stage. Unintentional weight loss, early satiety (feeling full after consuming only a small amount of food), persistent indigestion and abdominal pain are the most common symptoms. Other presentations can include dysphagia (difficulty swallowing), nausea, vomiting, and black tarry stools (indicating gastrointestinal bleeding).
The only SOP worsening factor is for inability to obtain appropriate clinical management. Most people present with advanced, incurable disease and have a poor prognosis even with treatment.
Place holder node for Rulebase for malignant neoplasm of the stomach
Malignant neoplasm of the stomach - A course of therapeutic radiation Factor
Last reviewed for CCPS 16 July 2003.
Preliminary questions [1379]
7629 [5] there is some evidence that therapeutic radiation may be a factor in the development of the condition under consideration.
24709 [6] the veteran's malignant neoplasm of the stomach is a carcinoma of the stomach. the veteran has had a course of therapeutic radiation to the region of the stomach at some time.
24735 [8] the veteran underwent a course of therapeutic radiation to the region of the stomach, where the first exposure occurred at least ten years before the clinical onset of malignant neoplasm of the stomach. the course of therapeutic radiation to the region of the stomach, where the first exposure occurred at least ten years before the clinical onset of malignant neoplasm of the stomach, was given for an illness or injury which is identifiable. [10]
24736 — the veteran has established the causal connection between the course of therapeutic radiation to the region of the stomach and VEA service for the clinical onset of malignant neoplasm of the stomach.
5188 — the veteran has established the causal connection between the course of therapeutic radiation to the region of the stomach and operational service for the clinical onset of malignant neoplasm of the stomach.
or
24737 — the veteran has established the causal connection between the course of therapeutic radiation to the region of the stomach and eligible service for the clinical onset of malignant neoplasm of the stomach.
Clinical onset and operational service [5188]
1402 — the identified illness or injury for which the veteran had a course of therapeutic radiation to the region of the stomach is causally related to operational service. [11] [12]
Clinical onset and eligible service [24737]
24741 — the identified illness or injury for which the veteran had a course of therapeutic radiation to the region of the stomach is causally related to eligible service. [13] [12]
Malignant neoplasm of the stomach - Atomic radiation Factor
Last reviewed for CCPS 16 July 2003.
Investigative Documents
Claimant Report - Exposure to Atomic Radiation [CR9171] Preliminary questions [1378]
24709 [6] the veteran's malignant neoplasm of the stomach is a carcinoma of the stomach. 1776 — the veteran has established the causal connection between atomic radiation and VEA service for the clinical onset of malignant neoplasm of the stomach. 5179 — the veteran has established the causal connection between atomic radiation and operational service for the clinical onset of malignant neoplasm of the stomach. [Default true] or 5182 — the veteran has established the causal connection between atomic radiation and eligible service for the clinical onset of malignant neoplasm of the stomach. [Default true] Clinical onset and operational service [5179] Clinical onset and eligible service [5182]
Malignant neoplasm of the stomach - Chronic atrophic gastritis Factor
Last reviewed for CCPS 16 July 2003.
Preliminary questions [24718]
24719 [22] there is some evidence that chronic atrophic gastritis may be a factor in the development of the condition under consideration.
24711 [23] the veteran's malignant neoplasm of the stomach is a carcinoma of the fundus, body, antrum or pylorus of the stomach. the veteran has suffered from chronic atrophic gastritis at some time.
24722 — the veteran has established the causal connection between the chronic atrophic gastritis and VEA service for the clinical onset of malignant neoplasm of the stomach.
24724 — the veteran has established the causal connection between the chronic atrophic gastritis and eligible service for the clinical onset of malignant neoplasm of the stomach.
or
24723 — the veteran has established the causal connection between the chronic atrophic gastritis and operational service for the clinical onset of malignant neoplasm of the stomach.
Clinical onset and operational service [24723]
24721 [25] the veteran suffered from chronic atrophic gastritis where the chronic atrophic gastritis commenced at least five years before the clinical onset of malignant neoplasm of the stomach. 24725 — the chronic atrophic gastritis is causally related to operational service. [26] [27] Clinical onset and eligible service [24724]
24726 — the chronic atrophic gastritis is causally related to eligible service. [30] [27]
Malignant neoplasm of the stomach - Cigar smoking Factor
Last reviewed for CCPS 16 July 2003.
Investigative Documents
Claimant Report - Smoking [CRD905] [31] Claimant Report - Smoking [CRV905] Preliminary questions [24742]
24709 [6] the veteran's malignant neoplasm of the stomach is a carcinoma of the stomach. 24744 — the veteran has established the causal connection between the cigar smoking and VEA service for the clinical onset of malignant neoplasm of the stomach. 24745 — the veteran has established the causal connection between the cigar smoking and operational service for the clinical onset of malignant neoplasm of the stomach. or 24746 — the veteran has established the causal connection between the cigar smoking and eligible service for the clinical onset of malignant neoplasm of the stomach. Clinical onset and operational service [24745] 24747 — the veteran has smoked at least 15 pack years of cigars before the clinical onset of the malignant neoplasm of the stomach and, where smoking has ceased, the clinical onset of the malignant neoplasm of the stomach occurred within 25 years of cessation. [7] 4921 — the veteran has some period or periods of cigar smoking that are causally related to operational service. [34] Clinical onset and eligible service [24746] 24748 — the veteran has smoked at least 25 pack years of cigars before the clinical onset of the malignant neoplasm of the stomach and, where smoking has ceased, the clinical onset of the malignant neoplasm of the stomach occurred within 15 years of cessation. [35]
4922 — the veteran has some period or periods of cigar smoking that are causally related to eligible service. [38]
Malignant neoplasm of the stomach - Cigarette smoking Factor
Last reviewed for CCPS 16 July 2003.
Investigative Documents
Claimant Report - Smoking [CRD905] [31] Claimant Report - Smoking [CRV905] Preliminary questions [21813] 21814 — the veteran has established the causal connection between the cigarette smoking and VEA service for the clinical onset of malignant neoplasm of the stomach. 4035 — the veteran has established the causal connection between the cigarette smoking and operational service for the clinical onset of malignant neoplasm of the stomach. or 4202 — the veteran has established the causal connection between the cigarette smoking and eligible service for the clinical onset of malignant neoplasm of the stomach. Clinical onset and operational service [4035] 5177 — the veteran has smoked at least fifteen pack years of cigarettes before the clinical onset of the malignant neoplasm of the stomach and, where smoking has ceased, the clinical onset of the malignant neoplasm of the stomach occurred within 25 years of cessation. [39] 3116 — the veteran has some period or periods of cigarette smoking that are causally related to operational service. [41] Clinical onset and eligible service [4202] 24710 — the veteran has smoked at least 25 pack years of cigarettes before the clinical onset of the malignant neoplasm of the stomach and, where smoking has ceased, the clinical onset of the malignant neoplasm of the stomach occurred within 15 years of cessation. [42]
3521 — the veteran has some period or periods of cigarette smoking that are causally related to eligible service. [45]
Malignant neoplasm of the stomach - Infection with Helicobacter pylori Factor
Last reviewed for CCPS 16 July 2003.
Investigative Documents
Medical Report - Helicobacter Pylori Infection - Malignant Neoplasm of the Stomach [MR9228] Preliminary questions [6669]
24712 [47] the veteran was infected with Helicobacter pylori at least ten years before the clinical onset of malignant neoplasm of the stomach. 24713 — the veteran has established the causal connection between the infection with Helicobacter pylori and VEA service for the clinical onset of malignant neoplasm of the stomach. 6670 — the veteran has established the causal connection between the infection with Helicobacter pylori and operational service for the clinical onset of malignant neoplasm of the stomach. or 24714 — the veteran has established the causal connection between the infection with Helicobacter pylori and eligible service for the clinical onset of malignant neoplasm of the stomach. Clinical onset and operational service [6670] Clinical onset and eligible service [24714]
Malignant neoplasm of the stomach - No appropriate clinical management for malignant neoplasm of the stomach Factor
Last reviewed for CCPS 16 July 2003.
Investigative Documents
Medical Report - Inability to Obtain Appropriate Clinical Management - [GQACM] Preliminary questions [5204] 11109 — the condition under consideration has been accepted on the basis of inability to obtain appropriate clinical management for the condition under consideration.
7334 [52] the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service. the condition under consideration permanently worsened. the veteran was unable to obtain appropriate clinical management for the condition under consideration at some time.
7379 [55] the inability to obtain appropriate clinical management for the condition under consideration contributed to the clinical worsening of the condition under consideration. 11234 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and VEA service for the clinical worsening of the condition under consideration. 11235 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and operational service for the clinical worsening of the condition under consideration. or 11236 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and eligible service for the clinical worsening of the condition under consideration. Clinical worsening and operational service [11235] or 7390 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to operational service. [59] [60] Clinical worsening and eligible service [11236] or 7391 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to eligible service. [59] [60]
Malignant neoplasm of the stomach - Partial gastrectomy Factor
Last reviewed for CCPS 16 July 2003.
Preliminary questions [1377]
7628 [67] there is some evidence that a partial gastrectomy may be a factor in the development of the condition under consideration.
24711 [23] the veteran's malignant neoplasm of the stomach is a carcinoma of the fundus, body, antrum or pylorus of the stomach. the veteran has undergone a partial gastrectomy at some time.
24727 [68] the veteran has undergone a partial gastrectomy at least 15 years before the clinical onset of malignant neoplasm of the stomach. 1388 — the veteran has established the causal connection between the partial gastrectomy and operational service for the clinical onset of malignant neoplasm of the stomach. Clinical onset and operational service [1388] or
1389 — the identified illness or injury for which the partial gastrectomy was performed is causally related to operational service. [72]
Malignant neoplasm of the stomach - Pipe smoking Factor
Last reviewed for CCPS 16 July 2003.
Investigative Documents
Claimant Report - Smoking [CRD905] [31] Claimant Report - Smoking [CRV905] Preliminary questions [24749]
24709 [6] the veteran's malignant neoplasm of the stomach is a carcinoma of the stomach. 24751 — the veteran has established the causal connection between the pipe smoking and VEA service for the clinical onset of malignant neoplasm of the stomach. 24752 — the veteran has established the causal connection between the pipe smoking and operational service for the clinical onset of malignant neoplasm of the stomach. or 24753 — the veteran has established the causal connection between the pipe smoking and eligible service for the clinical onset of malignant neoplasm of the stomach. Clinical onset and operational service [24752] 24754 — the veteran has smoked at least 15 pack years of pipe tobacco before the clinical onset of the malignant neoplasm of the stomach and, where smoking has ceased, the clinical onset of the malignant neoplasm of the stomach occurred within 25 years of cessation. [7] 4911 — the veteran has some period or periods of pipe smoking that are causally related to operational service. [75] Clinical onset and eligible service [24753] 24755 — the veteran has smoked at least 25 pack years of pipe tobacco before the clinical onset of the malignant neoplasm of the stomach and, where smoking has ceased, the clinical onset of the malignant neoplasm of the stomach occurred within 15 years of cessation. [76]
4913 — the veteran has some period or periods of pipe smoking that are causally related to eligible service. [79]
Malignant neoplasm of the stomach - Smoking tobacco products - material contribution Factor
Last reviewed for CCPS 16 July 2003.
Investigative Documents
Claimant Report - Smoking [CRD905] [31] Claimant Report - Smoking [CRV905] Preliminary questions [35168] 35169 — the veteran has established the causal connection between smoking tobacco products and VEA service for the clinical onset of malignant neoplasm of the stomach. 35170 — the veteran has established the causal connection between smoking tobacco products and operational service for the clinical onset of malignant neoplasm of the stomach. or 35171 — the veteran has established the causal connection between smoking tobacco products and eligible service for the clinical onset of malignant neoplasm of the stomach. Clinical onset and operational service [35170] Clinical onset and eligible service [35171]
Links
[1] http://www.rma.gov.au/assets/SOP/2023/3956562953/074.pdf
[2] http://www.rma.gov.au/assets/SOP/2023/f7b99f3c37/075.pdf
[3] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20237_0.pdf
[4] https://clik.dva.gov.au/user/login?destination=comment/reply/63816%23comment-form
[5] https://clik.dva.gov.au/ccpsb029rc-15
[6] https://clik.dva.gov.au/ccpsb002rc-7
[7] clikpopup://CCPS/reject24709No
[8] clikpopup://CCPS/Therapeutic radiation, first exposure 10 years before onset MN stomach
[9] clikpopup://CCPS/reject24735No
[10] clikpopup://CCPS/reject24740No
[11] clikpopup://CCPS/reject1402No
[12] clikpopup://CCPS/reject1402,24741No
[13] clikpopup://CCPS/reject24741No
[14] https://clik.dva.gov.au/ccpsclaimant-240
[15] clikpopup://CCPS/reject6695No
[16] clikpopup://CCPS/reject6696No
[17] clikpopup://CCPS/reject35167No
[18] clikpopup://CCPS/rejectwilful
[19] clikpopup://CCPS/reject33110No
[20] clikpopup://CCPS/reject33112No
[21] clikpopup://CCPS/reject33111No
[22] https://clik.dva.gov.au/standard-commentary-144
[23] clikpopup://CCPS/MN stomach is carcinoma of fundus, body, antrum or pylorus of the stomach
[24] clikpopup://CCPS/reject24711No
[25] clikpopup://CCPS/Chronic atrophic gastritis 5 years before onset MN stomach
[26] clikpopup://CCPS/reject24721No
[27] clikpopup://CCPS/reject24725,24726No
[28] clikpopup://CCPS/Chronic atrophic gastritis 15 years before onset MN stomach
[29] clikpopup://CCPS/reject24729No
[30] clikpopup://CCPS/reject24726No
[31] https://clik.dva.gov.au/ccpsclaimant-115
[32] clikpopup://CCPS/Cigar smoking
[33] clikpopup://CCPS/Cigar smoking started 15 years before onset
[34] clikpopup://CCPS/reject32302No
[35] clikpopup://CCPS/reject24748No
[36] clikpopup://CCPS/Cigar smoking started 20 years before onset
[37] clikpopup://CCPS/203reject32273
[38] clikpopup://CCPS/reject4922No
[39] clikpopup://CCPS/reject5803No
[40] https://clik.dva.gov.au/21813-cigarette-smoking
[41] clikpopup://CCPS/reject32296No
[42] clikpopup://CCPS/reject24710No
[43] clikpopup://CCPS/Cigarette smoking started 20 years before onset
[44] clikpopup://CCPS/203reject32270
[45] clikpopup://CCPS/reject3521No
[46] https://clik.dva.gov.au/ccpsmedical-5
[47] clikpopup://CCPS/Helicobacter pylori infection 10 years prior to onset of MN of the stomach
[48] clikpopup://CCPS/reject24712No
[49] clikpopup://CCPS/reject6672No
[50] clikpopup://CCPS/reject24716No
[51] https://clik.dva.gov.au/ccpsother-31
[52] https://clik.dva.gov.au/node/71143
[53] clikpopup://CCPS/Reject/OnsetAfterService
[54] clikpopup://CCPS/Reject/NoPermanentWorsening
[55] clikpopup://CCPS/Malignant neoplasm of the stomach/ACM %C2%96 contributed to worsening
[56] clikpopup://CCPS/ACM/NoContribution
[57] clikpopup://CCPS/ACM/NotOpService
[58] clikpopup://CCPS/ACM/NotOperDuties
[59] clikpopup://CCPS/ACM/NoIllness
[60] clikpopup://CCPS/reject7390,7391No
[61] clikpopup://CCPS/Malignant neoplasm of the stomach/ACM %C2%96 onset prior to operational service
[62] clikpopup://CCPS/ACM/OnsetFailOper
[63] clikpopup://CCPS/ACM/NotEligService
[64] clikpopup://CCPS/ACM/NotEligDuties
[65] clikpopup://CCPS/Malignant neoplasm of the stomach/ACM %C2%96 onset prior to eligible service
[66] clikpopup://CCPS/ACM/OnsetFailElig
[67] https://clik.dva.gov.au/partial-gastrectomy
[68] clikpopup://CCPS/Partial gastrectomy 15 years before onset MN stomach
[69] clikpopup://CCPS/reject24727No
[70] clikpopup://CCPS/reject24730No
[71] clikpopup://CCPS/reject4164No
[72] clikpopup://CCPS/reject1389No
[73] clikpopup://CCPS/Pipe smoking
[74] clikpopup://CCPS/Pipe smoking started 15 years before onset
[75] clikpopup://CCPS/reject32309No
[76] clikpopup://CCPS/reject24755No
[77] clikpopup://CCPS/Pipe smoking started 20 years before onset
[78] clikpopup://CCPS/203reject32277
[79] clikpopup://CCPS/reject4913No
[80] clikpopup://CCPS/reject30303No
[81] clikpopup://CCPS/reject35172No
[82] clikpopup://CCPS/reject35174No
[83] clikpopup://CCPS/reject35176No
[84] clikpopup://CCPS/reject35173No
[85] clikpopup://CCPS/reject35175No
[86] clikpopup://CCPS/reject35177No