Attention: This bulletin has been superseded and is inactive.
EEOICPA BULLETIN NO.02-15
Effective Date: June 12, 2002
Expiration Date: June 12, 2003
Subject: Chondrosarcoma of the Cricoid Cartilage of the Larynx as a Specified Primary Cancer
Background: The Department of Labor (DOL) recently forwarded the medical evidence in a case file to the National Cancer Institute (NCI) for their review and opinion to determine if, for purposes of being considered a specified cancer under the EEOICPA, chondrosarcoma of the cricoid cartilage of the larynx can be considered a bone cancer.
The expert medical opinion obtained from the NCI indicates that while it is possible to make histologic distinctions between chondrosarcomas and osteosarcomas, the biologic and neoplastic aspects of cartilaginous and calcified bony tissue share many characteristics in common and seem to be vulnerable to similar influences. There is a good deal of evidence that radiation effects on the bony skeleton and the non-calcified cartilaginous tissue are likely to be quite similar, and the NCI expert was aware of no evidence to the contrary. Thus, it seems to the expert that a sarcoma arising in the cricoid would fit under the general rubric of a bone cancer.
Accordingly, for purposes of being considered a specified cancer under the EEOICPA, DOL has determined that chondrosarcoma of the cricoid cartilage of the larynx will be considered as a bone cancer.
Reference: Energy Employees Occupational Illness Compensation Program Act of 2000, As Amended, 42 U.S.C. § 7384 et seq., Sections 7384l (14) and (17) and a letter from Dr. R. Kaplan, NCI, to Dr. V. Miller, DOL, dated June 12, addressing this chondrosarcoma case (see Docket No.4230-2002).
Purpose: To notify District Offices that chondrosarcoma of the cricoid cartilage of the larynx is considered a bone cancer, which is a specified primary cancer for eligible SEC claimants under the EEOICPA.
Applicability: All staff.
1. The CE should consider chondrosarcoma of the cricoid cartilage of the larynx as a specified primary cancer in determining eligibility for members of the Special Exposure Cohort (SEC) per EEOICPA Section 7384l(14). The rationale is that the biologic and neoplastic aspects of cartilaginous and calcified bony tissue share many characteristics in common and seem to be vulnerable to similar influences.
2. The CE should look for any other cases with this type cancer that could be eligible as members of the SEC. A preliminary review of the ECMS searching for ICD-9 code 161.3 did not find any other employees at SEC sites, however the cancer may have not been entered into ECMS using this code.
3. The CE should review all incoming SEC claims for this condition. If found, and all other relevant SEC criteria have been met, issue a Recommended Decision for acceptance of the claim as bone cancer.
4. The CE should continue to distinguish chondrosarcoma of the cricoid cartilage of the larynx from bone cancers using the appropriate ICD-9 codes on all paperwork and in ECMS. For example, the ICD-9 codes for a malignant neoplasm of the laryngeal cartilage is 161.3, and for bone it is 170.
Disposition: Retain until incorporated in the Federal (EEOICPA) Procedure Manual
PETER M. TURCIC
Director, Division of Energy Employees
Occupational Illness Compensation
Distribution List No. 1: Claims Examiners, Supervisory Claims Examiners, Technical Assistants, Customer Service Representatives, Fiscal Officers, FAB District Managers, Operation Chiefs, Hearing Representatives, District Office Mail & File Sections