Health risk assessments can be considered separately from safety risk assessments. Depending on the jurisdiction and the industry under consideration, health risk assessments may be addressed either as discrete workplace risk assessments or folded into a comprehensive workplace hazard and risk assessment. Risk assessments include both an estimate of the probability that a hazard could cause harm to human health and an evaluation of the potential severity of the damage that could be caused by the hazard. All rights reserved.Safeopedia Explains Health Risk Assessment (HRA) Individuals with HRA and synchronous large SP or any STSA could therefore benefit from close surveillance.Ĭolon Cancer Early Detection NHCR Risk Factors.Ĭopyright © 2018 AGA Institute. HRA and synchronous SPs at index colonoscopy significantly increased risk of metachronous HRA. In an analysis of data from a population-based colonoscopy registry, we found index large SP or index STSA with no index HRA increased risk of metachronous large SPs but not metachronous HRA. Large index SPs alone (OR, 14.34 95% CI, 5.03-40.86) or index STSA alone (OR, 9.70 95% CI, 3.63-25.92) significantly increased the risk of a large metachronous SP. HRA and synchronous large SP (odds ratio, 5.61 95% confidence interval, 1.72-18.28), HRA with synchronous STSA (OR, 16.04 95% CI, 6.95-37.00), and HRA alone (OR, 3.86 95% CI, 2.77-5.39) at index colonoscopy significantly increased the risk of metachronous HRA compared to the reference group (no index adenomas or SPs). In this study, SSA/Ps and traditional serrated adenomas are referred to collectively as STSAs. SPs comprise hyperplastic polyps, sessile serrated adenomas/polyps (SSA/Ps), and traditional serrated adenomas. Synchronous SPs, within each index risk group, were assessed for size and by histology. We used multivariable logistic regression models to assess effects of index SPs (n = 1016), high-risk adenomas (HRA, n = 817), low-risk adenomas (n = 1418), and no adenomas (n = 3198) on subsequent HRA or large SPs (>1 cm) on surveillance colonoscopy (metachronous lesions). Our analyses included 5433 participants (median age, 61 years 49.7% male) with 2 colonoscopies (median time to surveillance, 4.9 years). Patients completed a questionnaire to determine demographic characteristics, health history, and risk factors for colorectal cancer, and were followed from index colonoscopy through all subsequent surveillance colonoscopies. We collected data from a population-based colonoscopy registry that has been collecting and analyzing data on colonoscopies across the state of New Hampshire since 2004, including rates of adenoma and SP detection.

We used the New Hampshire Colonoscopy Registry to evaluate risk of clinically important metachronous lesions associated with SPs detected during index colonoscopies. Surveillance guidelines for serrated polyps (SPs) are based on limited data on longitudinal outcomes of patients. 6 Brigham and Women's Hospital, Boston, Massachusetts.5 Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.4 Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.3 Section of Gastroenterology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.Electronic address: 2 Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire Section of Gastroenterology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire. 1 Department of Veterans Affairs Medical Center, White River Junction, Vermont Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.

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