Patients’ Attitude toward Less Frequent Surveillance of Low-Risk Pancreatic Cysts: A Multicenter European Cohort Study

Background Recent studies show that low-risk pancreatic cysts may require less frequent monitoring. Future guidelines will likely adapt their recommendations accordingly. Our goal was to explore the willingness of individuals with a low-risk pancreatic cyst to undergo less frequent surveillance and to identify associated characteristics with such willingness.Methods This is a side study of the international PACYFIC study, which prospectively collects data on cyst surveillance, including questionnaires to assess participants' attitude toward surveillance. Individuals with low-risk cysts at baseline, without given standardized information by the study protocol, were enrolled. Their responses to the baseline question, "Would you prefer less frequent surveillance? Yes/No," were correlated with baseline characteristics using multivariable logistic regression, namely, age, country of residence, symptoms, medical and family history, time since first cyst detection, and Hospital Anxiety Depression Scale score.Results Of the 215 participants included from the Netherlands (n = 185) and Italy (n = 30), only 47 (22%) were willing to undergo less surveillance. Characteristics positively associated with this willingness were older age (odds ratio [OR] 1.87 per 10 y, 95% confidence interval [CI]: 1.15-3.04) and Italian residency (OR 16.35, 95% CI: 5.65-47.31). A medical history of cancer was negatively associated (OR 0.28, 95% CI: 0.09-0.90). No other associations were observed.Conclusion Most participants appear unwilling to undergo less frequent cyst surveillance. Older age and residing in Italy were associated with a greater willingness toward less rigorous surveillance, while a history of cancer did the opposite. Identifying which individuals are hesitant to undergo less frequent surveillance may help clinicians tailor their counseling and can support implementation of future guideline with fewer surveillance recommendations.