{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T02:40:14Z","timestamp":1793155214241,"version":"4.5.0"},"reference-count":41,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Subsets of pancreatic cystic lesions (PCLs) are the only radiographically evident precursors to pancreatic cancer. Guidelines prioritize cyst size and high-risk features to determine the need for resection. However, the true prevalence of PCLs and risk factors for their development in the general population remain unknown, as available data are often biased by imaging performed in symptomatic patients.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine prevalence of PCLs in an asymptomatic North American cohort using size-based risk categorization and identify associated demographic factors and exposures.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, Participants<\/jats:title>\n This cross-sectional study included asymptomatic individuals who underwent rapid whole-body magnetic resonance imaging using a commercially available 1.5T device for general preventive screening between January 1, 2020, and May 31, 2023. Scans were interpreted by certified radiologists using standardized synoptic reporting templates. Diagnostic free-text reports were analyzed, and positive reports underwent independent additional review. Data were analyzed from February 4, 2024, to March 6, 2025.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Participant demographic information and lifestyle exposures.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Prevalence of PCLs based on size-based risk categorization.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 21\u202f651 individuals undergoing screening MRI (11 050 [51.0%] male; median age, 51 [IQR, 42-61] years), 1509 (7.0%) had an incidental PCL (776 [51.4%] female), and age- and sex-standardized prevalence was 6.3%. The median age was higher in individuals with PCLs (61 [IQR, 51-69] vs 50 [IQR, 41-60] years). Prevalence increased with age, from 86 of 4223 (2.0%) 39 years or younger to 229 of 5720 (4.0%) aged 40 to 49 years, 390 of 5586 (7.0%) aged 50 to 59 years, 467 of 4049 (11.5%) aged 60 to 65 years, 268 of 1741 (15.4%) aged 70 to 79 years, and 69 of 332 (20.8%) 80 years or older (\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). Most cysts (1449 [96.0%]) were less than 2 cm, 1200 (79.5%) were less than 1 cm, and 17 (1.1%) were 3 cm or larger (0.08% of all scans). Independent factors associated with PCLs included being 65 years or older (odds ratio [OR], 3.03; 95% CI, 2.67-3.45), female sex (OR, 1.13; 95% CI, 1.002-1.27), personal history of pancreatitis (OR, 2.65; 95% CI, 1.66-4.08) or pancreatic ductal adenocarcinoma (PDAC) (OR, 20.98; 95% CI 3.70-161.45), family history of PDAC (OR, 1.40; 95% CI, 1.04-1.86), alcohol consumption (OR, 1.15; 95% CI, 1.01-1.31), and Latin American (OR, 1.79; 95% CI, 1.43-2.23) or Middle Eastern (OR, 1.40; 95% CI, 1.03-1.86) ethnicity. Asian ethnicity (OR, 0.79; 95% CI, 0.66-0.95) was associated with lower PCL prevalence.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cross-sectional study of 21\u202f651 individuals, incidental PCLs were common (6.3%) and found in as many as 20.8% of older individuals undergoing whole-body MRI screening, with 1492 PCLs (98.9%) of all PCLs being less than 3 cm.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.0983","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T15:00:26Z","timestamp":1773068426000},"page":"e260983","source":"Crossref","is-referenced-by-count":3,"title":["Prevalence and Size-Based Risk Categorization of Pancreatic Cysts Among Asymptomatic Individuals With Screening MRI"],"prefix":"10.1001","volume":"9","author":[{"given":"Paul","family":"Wong","sequence":"first","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, University of California, San Francisco, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Pollini","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, University of California, San Francisco, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, University of California, San Francisco, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Zampese","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, University of California, San Francisco, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letizia","family":"Todeschini","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, University of California, San Francisco, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Laurean","family":"Aguilar","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, University of California, San Francisco, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saqib Abdullah","family":"Basar","sequence":"additional","affiliation":[{"name":"Prenuvo Inc, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Hashemi","sequence":"additional","affiliation":[{"name":"Prenuvo Inc, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay V.","family":"Maker","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, University of California, San Francisco, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"issue":"6","key":"zoi260063r1","doi-asserted-by":"publisher","first-page":"1213","DOI":"10.1016\/j.pan.2020.08.003","article-title":"Risk of malignancy in small pancreatic cysts decreases over time.","volume":"20","author":"Ciprani","year":"2020","journal-title":"Pancreatology"},{"issue":"10","key":"zoi260063r2","doi-asserted-by":"publisher","first-page":"e2338696","DOI":"10.1001\/jamanetworkopen.2023.38696","article-title":"IPMNs of the pancreas: more epidemiologically than clinically relevant.","volume":"6","author":"Crippa","year":"2023","journal-title":"JAMA Netw Open"},{"issue":"9","key":"zoi260063r3","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1056\/NEJMra2309041","article-title":"Pancreatic Cysts.","volume":"391","author":"Gonda","year":"2024","journal-title":"N Engl J Med"},{"issue":"3","key":"zoi260063r4","doi-asserted-by":"publisher","first-page":"802","DOI":"10.2214\/AJR.07.3340","article-title":"Prevalence of unsuspected pancreatic cysts on MDCT.","volume":"191","author":"Laffan","year":"2008","journal-title":"AJR Am J Roentgenol"},{"issue":"51","key":"zoi260063r5","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000005535","article-title":"Incidental pancreatic cystic neoplasms in an asymptomatic healthy population of 21,745 individuals: large-scale, single-center cohort study.","volume":"95","author":"Chang","year":"2016","journal-title":"Medicine (Baltimore)"},{"issue":"3","key":"zoi260063r6","doi-asserted-by":"publisher","first-page":"722","DOI":"10.2214\/AJR.08.1253","article-title":"Comparative performance of MDCT and MRI with MR cholangiopancreatography in characterizing small pancreatic cysts.","volume":"193","author":"Sainani","year":"2009","journal-title":"AJR Am J Roentgenol"},{"issue":"1","key":"zoi260063r7","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1002\/jmri.21001","article-title":"Differentiation of intraductal papillary mucinous neoplasms from other pancreatic cystic masses: comparison of multirow-detector CT and MR imaging using ROC analysis.","volume":"26","author":"Song","year":"2007","journal-title":"J Magn Reson Imaging"},{"issue":"5","key":"zoi260063r8","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1136\/gutjnl-2018-316027","article-title":"European evidence-based guidelines on pancreatic cystic neoplasms.","volume":"67","author":"Del Chiaro","year":"2018","journal-title":"Gut"},{"issue":"4","key":"zoi260063r9","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1053\/j.gastro.2015.01.015","article-title":"American gastroenterological association institute guideline on the diagnosis and management of asymptomatic neoplastic pancreatic cysts.","volume":"148","author":"Vege","year":"2015","journal-title":"Gastroenterology"},{"issue":"9","key":"zoi260063r10","doi-asserted-by":"publisher","first-page":"1798","DOI":"10.1016\/j.cgh.2024.02.018","article-title":"Global prevalence of pancreatic cystic lesions in the general population on magnetic resonance imaging: a systematic review and meta-analysis.","volume":"22","author":"Vilela","year":"2024","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"3","key":"zoi260063r11","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1007\/BF02784942","article-title":"Analysis of small cystic lesions of the pancreas.","volume":"18","author":"Kimura","year":"1995","journal-title":"Int J Pancreatol"},{"issue":"3","key":"zoi260063r12","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/j.pan.2012.04.004","article-title":"International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas.","volume":"12","author":"Tanaka","year":"2012","journal-title":"Pancreatology"},{"issue":"5","key":"zoi260063r13","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1016\/j.pan.2017.07.007","article-title":"Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas.","volume":"17","author":"Tanaka","year":"2017","journal-title":"Pancreatology"},{"issue":"2","key":"zoi260063r14","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1016\/j.pan.2023.12.009","article-title":"International evidence-based Kyoto guidelines for the management of intraductal papillary mucinous neoplasm of the pancreas.","volume":"24","author":"Ohtsuka","year":"2024","journal-title":"Pancreatology"},{"issue":"3","key":"zoi260063r17","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1245\/s10434-022-12870-w","article-title":"The landmark series: intraductal papillary mucinous neoplasms of the pancreas\u2014from prevalence to early cancer detection.","volume":"30","author":"Pollini","year":"2023","journal-title":"Ann Surg Oncol"},{"issue":"9","key":"zoi260063r18","doi-asserted-by":"publisher","first-page":"2079","DOI":"10.1038\/ajg.2010.122","article-title":"Prevalence of incidental pancreatic cysts in the adult population on MR imaging.","volume":"105","author":"Lee","year":"2010","journal-title":"Am J Gastroenterol"},{"issue":"9","key":"zoi260063r19","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1016\/j.cgh.2010.05.017","article-title":"High prevalence of pancreatic cysts detected by screening magnetic resonance imaging examinations.","volume":"8","author":"de Jong","year":"2010","journal-title":"Clin Gastroenterol Hepatol"},{"key":"zoi260063r20","doi-asserted-by":"publisher","first-page":"407","DOI":"10.12659\/PJR.897570","article-title":"Whole-body MRI screening in asymptomatic subjects; preliminary experience and long-term follow-up findings.","volume":"81","author":"Ulus","year":"2016","journal-title":"Pol J Radiol"},{"issue":"6","key":"zoi260063r21","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1097\/MPA.0000000000000833","article-title":"Prevalence of pancreatic cystic lesions is associated with diabetes mellitus and obesity: an analysis of 5296 individuals who underwent a preventive medical examination.","volume":"46","author":"Mizuno","year":"2017","journal-title":"Pancreas"},{"issue":"1","key":"zoi260063r22","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1136\/gutjnl-2016-313127","article-title":"Prospective study on the incidence, prevalence and 5-year pancreatic-related mortality of pancreatic cysts in a population-based study.","volume":"67","author":"Kromrey","year":"2018","journal-title":"Gut"},{"issue":"3","key":"zoi260063r23","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1053\/j.gastro.2024.02.041","article-title":"Diagnosis and management of pancreatic cysts.","volume":"167","author":"Gardner","year":"2024","journal-title":"Gastroenterology"},{"issue":"3","key":"zoi260063r24","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1038\/nrgastro.2011.2","article-title":"Cystic precursors to invasive pancreatic cancer.","volume":"8","author":"Matthaei","year":"2011","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"1","key":"zoi260063r25","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/474905","article-title":"Precursor lesions for sporadic pancreatic cancer: PanIN, IPMN, and MCN.","volume":"2014","author":"Distler","year":"2014","journal-title":"Biomed Res Int"},{"issue":"3","key":"zoi260063r26","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0121317","article-title":"Prevalence of incidental pancreatic cysts on 3 tesla magnetic resonance.","volume":"10","author":"de Oliveira","year":"2015","journal-title":"PLoS One"},{"issue":"3","key":"zoi260063r27","doi-asserted-by":"publisher","first-page":"740","DOI":"10.1053\/j.gastro.2018.05.035","article-title":"Risk of neoplastic progression in individuals at high risk for pancreatic cancer undergoing long-term surveillance.","volume":"155","author":"Canto","year":"2018","journal-title":"Gastroenterology"},{"issue":"4","key":"zoi260063r28","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1053\/j.gastro.2012.01.005","article-title":"Frequent detection of pancreatic lesions in asymptomatic high-risk individuals.","volume":"142","author":"Canto","year":"2012","journal-title":"Gastroenterology"},{"issue":"6","key":"zoi260063r29","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1016\/j.cgh.2006.02.005","article-title":"Screening for early pancreatic neoplasia in high-risk individuals: a prospective controlled study.","volume":"4","author":"Canto","year":"2006","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"4","key":"zoi260063r30","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1016\/j.pan.2012.05.011","article-title":"Intraductal papillary mucinous neoplasms: does a family history of pancreatic cancer matter?","volume":"12","author":"Nehra","year":"2012","journal-title":"Pancreatology"},{"issue":"7","key":"zoi260063r31","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1016\/j.cgh.2018.01.049","article-title":"Risk of pancreatic cancer in patients with pancreatic cysts and family history of pancreatic cancer.","volume":"16","author":"Mukewar","year":"2018","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"4","key":"zoi260063r32","doi-asserted-by":"publisher","first-page":"1016","DOI":"10.1053\/j.gastro.2023.06.022","article-title":"Surveillance for presumed BD-IPMN of the pancreas: stability, size, and age identify targets for discontinuation.","volume":"165","author":"Marchegiani","year":"2023","journal-title":"Gastroenterology"},{"issue":"2","key":"zoi260063r33","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1097\/SLA.0000000000006835","article-title":"San Francisco is not Sendai\u2014when do we stop surveillance of pancreatic cysts?","volume":"283","author":"Maker","year":"2026","journal-title":"Ann Surg"},{"issue":"11","key":"zoi260063r34","doi-asserted-by":"publisher","first-page":"1434","DOI":"10.1007\/s11547-021-01392-2","article-title":"Whole-body magnetic resonance imaging (WB-MRI) for cancer screening: recommendations for use.","volume":"126","author":"Petralia","year":"2021","journal-title":"Radiol Med"},{"issue":"11","key":"zoi260063r35","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0206681","article-title":"An initial experience with the use of whole body MRI for cancer screening and regular health checks.","volume":"13","author":"Lee","year":"2018","journal-title":"PLoS One"},{"issue":"3","key":"zoi260063r36","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1016\/j.giec.2023.03.001","article-title":"Burden of new pancreatic cyst diagnosis.","volume":"33","author":"Romutis","year":"2023","journal-title":"Gastrointest Endosc Clin N Am"},{"issue":"4","key":"zoi260063r37","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1016\/j.surg.2020.04.052","article-title":"Cost-effectiveness of consensus guideline based management of pancreatic cysts: the sensitivity and specificity required for guidelines to be cost-effective.","volume":"168","author":"Sharib","year":"2020","journal-title":"Surgery"},{"issue":"6","key":"zoi260063r38","doi-asserted-by":"publisher","first-page":"1746","DOI":"10.1245\/s10434-018-6425-6","article-title":"What is the incidence of malignancy in resected intraductal papillary mucinous neoplasms? an analysis of over 100 US institutions in a single year.","volume":"25","author":"Khoury","year":"2018","journal-title":"Ann Surg Oncol"},{"issue":"5","key":"zoi260063r39","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1016\/j.suc.2024.03.003","article-title":"Pancreas cyst diagnosis and advances in cyst fluid analysis.","volume":"104","author":"Pollini","year":"2024","journal-title":"Surg Clin North Am"},{"issue":"2","key":"zoi260063r40","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1007\/s00423-017-1644-z","article-title":"Can we better predict the biologic behavior of incidental IPMN? a comprehensive analysis of molecular diagnostics and biomarkers in intraductal papillary mucinous neoplasms of the pancreas.","volume":"403","author":"Tulla","year":"2018","journal-title":"Langenbecks Arch Surg"},{"issue":"5","key":"zoi260063r41","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1016\/j.jamcollsurg.2019.02.040","article-title":"Cyst fluid biosignature to predict intraductal papillary mucinous neoplasms of the pancreas with high malignant potential.","volume":"228","author":"Maker","year":"2019","journal-title":"J Am Coll Surg"},{"key":"zoi260063r15","unstructured":"Measuring physical activity intensity. Centers for Disease Control and Prevention. Reviewed June 3, 2022. Accessed January 28, 2025. https:\/\/www.cdc.gov\/physicalactivity\/basics\/measuring\/index.html"},{"key":"zoi260063r16","unstructured":"United States Population by Age and Sex. Accessed December 31, 2025. https:\/\/www.census.gov\/popclock\/data_tables.php?component=pyramid"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2846019\/wong_2026_oi_260063_1772485144.90107.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T15:00:27Z","timestamp":1773068427000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2846019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,9]]},"references-count":41,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3,2]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2026.0983","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,9]]}}}