Cancers Added to 9/11 Responder Coverage

WASHINGTON (CN) - The World Trade Center Health Program will consider four additional types of cancer for coverage, under an interim regulation.

The Department of Health and Human Services program provides medical monitoring and treatment for people affected by the collapse of the buildings on 9/11, such as first responders and cleanup workers.

On Tuesday, the agency issued an interim regulation adding brain cancer, pancreatic cancer, testicular cancer and invasive cervical cancer to a list of conditions considered for coverage. The health program also will review and reassess cases of brain and pancreatic cancer that have been denied certification previously, according to the interim regulation.

The four conditions are deemed "rare cancers" under the interim regulation's changed definition, which qualifies them for consideration.

Previously, the rarity of the disease was considered against all possible disease types. Now it is considered against all types of cancer only.

Also, the threshold for the number of cases qualifying a disease as rare had been related to the number of individuals in the United States living with a particular disease. Now, the threshold is related to the number of individuals in the United States that acquire a particular disease over a given time period. This removes life expectancy as a factor.

The program's Scientific/Technical Advisory Committee recommended adding a "rare cancers" category to the regulation, "as a precautionary measure," because it is difficult to gather statistics on them to determine whether they occur more often with 9/11 site exposure.

Under the interim regulation a "program member whose 9/11 exposure is found substantially likely to be a significant factor in aggravating, contributing to, or causing the individual's brain and/or pancreatic cancer, will be certified" for coverage. The program will review and reassess cases of brain and pancreatic cancer that have been denied certification.

In addition, the agency amended the definition of "childhood cancers" to clarify its meaning as a type of cancer diagnosed in people under 20 years old.

The agency also removed a "detailed list of sub-codes" which it said "unnecessarily constrains" the ability to determine which kinds of cancers are eligible for coverage.

"The total costs and benefits resulting from this regulatory action are due to brain cancer, invasive cervical cancer, pancreatic cancer, and testicular cancer being eligible for coverage by the program as `rare cancers,''' the agency wrote.

"The administrator [of the program] estimates the costs of medical treatment for the four cancers now considered eligible under the definition of rare cancers, as well as screening costs associated with invasive cervical cancer, to be between $2,287,933 and $4,933,280 annually for 2014 through 2016." (Brackets added.)

The interim regulation became effective Feb. 18, but the agency invites comments until April 21.

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