Attention: This bulletin has been superseded and is inactive.






Issue Date: July 15, 2002


Effective Date: June 12, 2002


Expiration Date: June 12, 2003


Subject:  Ureter Cancer 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, ureter cancer can be considered urinary bladder cancer.

The expert medical opinion obtained from the NCI indicates that superficial transitional cell carcinomas of the urinary epithelium are biologically identical wherever they arise within the urinary tract and indeed, they are often multifocal.  The etiologic (including environmental) influences on urothelial carcinogenesis and the tendency of patients who have developed a tumor in one location to develop additional tumors elsewhere in the urinary tract point to the clinical interchangeability of bladder and upper-tract transitional cell tumors.   The NCI expert’s opinion, therefore, is that it is logically inconsistent to treat those that arise within the bladder differently than those arising in the ureter or renal pelvis. 

For these reasons, the NCI expert considers that the ureter tumor belongs in the category with tumors of the urinary bladder.

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, 2002, addressing this ureter cancer case (see Docket No.4216-2002).

Purpose: To notify District Offices that ureter cancer is considered a urinary bladder cancer, which is a specified primary cancer for eligible SEC claimants under the EEOICPA.

Applicability: All staff. 


  1. The CE should consider ureter cancer as a urinary bladder cancer, which is a specified primary cancer per EEOICPA Section 7384l(17).
  1. 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 189.2 did not find any other employees at SEC sites, however the cancer may have not been entered into ECMS using this code. 
  1. 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 urinary bladder cancer.
  1. The CE should continue to distinguish ureter cancer from urinary bladder cancers using the appropriate ICD-9 codes on all paperwork and in ECMS. For example, the ICD-9 code for a malignant neoplasm of the ureter is 189.2, and for the urinary bladder it is 188.

Disposition:  Retain until incorporated in the Federal

(EEOICPA) Procedure Manual


  Director, Division of Energy Employees

  Occupational Illness Compensation

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