9/11 Responders Get Treatment for Cancers

     WASHINGTON (CN) – The World Trade Center Health Program has added dozens of cancers to the list of covered health conditions after a 2011 study showed an increase in cancer rates for first responders and survivors of the World Trade Center catastrophe, according to a Department of Health and Human Services rule.
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     The results of the epidemiologic study by Rachel Zeig-Owens and colleagues led to a petition to add cancer to the list, and after the program’s Scientific/Technical Advisory Committee recommended that certain types of cancer be added, the administrator of the program developed a method for determining which cancers to propose for inclusion, the action says.
     The list of added cancers includes “malignant neoplasms” of the mouth, larynx, esophagus, stomach, colon, liver, heart, respiratory system, skin, some reproductive organs, kidney, urinary organs, blood, and lymph tissues, as well as mesothelioma, some childhood cancers and rare cancers.
     “For an individual enrolled as a WTC responder or survivor to obtain coverage for treatment of any health condition on the List of WTC-Related Health Conditions, including any type of cancer added to the list, a two-step process must be satisfied,” the action states. A physician in the nationwide provider network must make a determination that the cancer is both on the list and that exposure from the Sept. 11, 2001 attacks is “substantially likely to be a significant factor in aggravating, contributing to, or causing the type of cancer for which the responder or survivor seeks treatment coverage,” the regulation notes.
     The physician’s determination is to be based on an assessment of the exposure, the type of symptoms reported and the sequence of those symptoms. Physician determinations also must be reviewed by the administrator and certified for treatment coverage, so the inclusion of a condition on the list does not guarantee that a particular individual’s condition will be certified as eligible for treatment, according to the action. Responders and survivors have a right to appeal the denial of certification.
     The criteria used to evaluate the causal relationship is based on the strength of the association between a 9/11 exposure and a health effect, consistency of the findings across multiple studies, “dose-response relationships between 9/11 exposures and the cancer type,” and known facts about the biology of the cancer type, the regulation states.
     Currently, approximately 55,000 New York City responders and 5,000 survivors are enrolled in the WTC Health Program, with a cap of 25,000 additional responders and 25,000 additional survivors that could be added in the future, according to the action. The program was established by the James Zadroga 9/11 Health and Compensation Act of 2010, and is administered by the Director of the National Institute for Occupational Safety and Health within the Center for Disease Control and Prevention.

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