Attention: This bulletin has been superseded and is inactive.
EEOICPA BULLETIN NO. 02-04
Issue Date: April 1, 2002
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Effective Date: April 1, 2002
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Expiration Date: April 1, 2003
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Subject: Rectal Cancer as a Specified Primary Cancer
Background: The District Offices have reviewed some Special Exposure Cohort (SEC) cases from gaseous diffusion plants where the only cancer diagnosis was rectal cancer. The specified cancer list in EEOICPA Section 7384l(17) includes colon cancer, but not rectal cancer. The intent of this Bulletin is to clarify the relationship of these two cancers and their inclusion as specified primary cancers under EEOICPA Section 7384l(17).
The colon and rectum form a long, muscular tube called the large intestine (also called the large bowel). The colon is the first 6 feet of the large intestine, and the rectum is the last 8 to 10 inches. The rectum is composed of the same tissue/cell type as the colon.
Because of this anatomical similarity, it is DOL’s intent to consider rectal cancer as the same as colon cancer. Consequently, rectal cancer should now be considered a primary specified cancer based on colon cancer being listed in EEOICPA Section 7384l(17) and used as such for determining eligibility for members of the Special Exposure Cohort (SEC) per EEOICPA Section 7384l(14).
Reference: Energy Employees Occupational Illness Compensation Program Act of 2000, As Amended, 42 U.S.C. § 7384 et seq., Sections 7384l (14) and (17).
Purpose: To notify District Offices to consider rectal cancer as similar to colon cancer, which is a specified primary cancer.
Applicability: All staff.
Actions:
1. The CE should consider rectal cancer as being the same as colon cancer, which is a specified primary cancer per EEOICPA Section 7384l(17). The rationale is based on the fact that the rectum and the colon are composed of the same tissue/cell types. Anatomically, it is appropriate to consider cancers of the colon and rectum to be the same.
2. Since colon and rectal cancers are considered anatomically similar, rectal cancer can now be considered as a specified primary cancer in determining eligibility for members of the Special Exposure Cohort (SEC) per EEOICPA Section 7384l(14).
3. The CE should continue to distinguish colon from rectal cancers using the appropriate ICD-9 codes on all appropriate paperwork. For example, the ICD-9 codes for a malignant neoplasm of the colon is 153 and for the rectum it is 154.1. For cancers that arise at the junction of these two areas, the ICD-9 code 154.0, for the rectosigmoid junction, can be used.
Disposition: Retain until incorporated in the Federal (EEOICPA) Procedure Manual.
PETER TURCIC
Director, Division of Energy Employees
Occupational Illness Compensation