Stop watching stable low-risk pancreatic cysts after five years
Small pancreatic cysts are found on many scans and followed for life. Evidence suggests those unchanged for five years rarely turn to cancer. A stopping rule would spare years of scans.
Low-risk branch-duct IPMN under 2 cm that is stable at five years has very low malignancy rates in Japanese and US cohorts, but guidelines diverge. Propose a randomised trial of surveillance cessation versus continued surveillance for stable low-risk cysts, with pancreatic cancer incidence and imaging burden as endpoints.
- Overdiagnosis and false alarms · Finding more cancer is not the same as saving lives. Screening also finds cancers that would never have hurt anyone, and treats them.
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