{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T23:45:09Z","timestamp":1788911109763,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:00:00Z","timestamp":1750204800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2025,7]]},"abstract":"ABSTRACT<\/jats:title>Background<\/jats:title>Pancreatic cysts are increasingly discovered on imaging studies performed for unrelated conditions. Currently, surveillance of these lesions poses a substantial burden on patients, and health care recourses. We hypothesized that individuals with small and stable cysts have a diminutive risk of progressing to high\u2010grade dysplasia (HGD) or pancreatic cancer (PC) that is similar to that in the general population.<\/jats:p><\/jats:sec>Methods<\/jats:title>This nested PACYFIC\u2010study is a collaboration among 44 centers in Europe and Northern\u2010America, and investigates the risk of HGD and PC for different cyst sizes and growth rates in participants without baseline worrisome features (WF) or high\u2010risk stigmata (HRS).<\/jats:p><\/jats:sec>Results<\/jats:title>Of the 2369 PACYFIC participants, 975 met the inclusion criteria, with a mean age of 67\u00a0years (SD 13) and 65% being female. Of these, 438 individuals (45%) had a baseline small cyst size (<\u00a015\u00a0mm), and 885 (91%) individuals had a slow growth rate (<\u00a02.5\u00a0mm\/year). During a median follow\u2010up of 45\u00a0months (IQR 27), 20 individuals (2.1%) developed HGD, or PC. Individuals with small cysts had a 1.5\u2010fold lower risk of developing WF or HRS (hazard ratio [HR] 0.7 [0.5\u20131.0], p<\/jats:italic>\u00a0=\u00a00.03) than those with larger cysts but a similar risk of developing HGD or PC (p<\/jats:italic>\u00a0>\u00a00.05). Slow growth was protective against the development of WF or HRS (HR 0.4 [0.2\u20130.6], p<\/jats:italic>\u00a0<\u00a00.001) and HGD or PC (HR 0.04 [95% CI 0.02\u20130.12], p<\/jats:italic>\u00a0<\u00a00.001). Individuals with small, stable sized cysts without baseline WF or HRS did not have a higher risk of HGD or PC than the general population (standardized incidence ratio [SIR] 1.13 [95% CI 0.01\u20136.30]).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Cyst size\u00a0<\u00a015\u00a0mm and growth rate\u00a0<\u00a02.5\u00a0mm\/year appear to be \u201creassuring\u201d features associated with a negligible risk of developing WF or HRS and HGD or PC. For cysts with these characteristics\u2014and without baseline WF or HRS\u2014less intensive surveillance (than currently recommended) or even cessation may be appropriate.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ueg2.70043","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T07:10:00Z","timestamp":1750230600000},"page":"971-981","source":"Crossref","is-referenced-by-count":10,"title":["Small and Stable Pancreatic Cysts Are Reassuring During Surveillance: Results From the PACYFIC Trial"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9825-8728","authenticated-orcid":false,"given":"Iris J. M.","family":"Levink","sequence":"first","affiliation":[{"name":"Department of Gastroenterology & Hepatology Erasmus University Medical Center Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marloes L. J. A.","family":"Sprij","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Erasmus University Medical Center Rotterdam the Netherlands"},{"name":"Department of Public Health Erasmus University Medical Center Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brechtje D. M.","family":"Koopmann","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Erasmus University Medical Center Rotterdam the Netherlands"},{"name":"Department of Public Health Erasmus University Medical Center Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4205-6860","authenticated-orcid":false,"given":"Jihane","family":"Meziani","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Erasmus University Medical Center Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanne","family":"Jaarsma","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Erasmus University Medical Center Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscilla A.","family":"van Riet","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Erasmus University Medical Center Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1829-9963","authenticated-orcid":false,"given":"Kasper A.","family":"Overbeek","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Erasmus University Medical Center Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6459-1434","authenticated-orcid":false,"given":"Myrte","family":"Gorris","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Amsterdam UMC Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9969-019X","authenticated-orcid":false,"given":"Rogier P.","family":"Voermans","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Amsterdam UMC Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanin E.","family":"van Hooft","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Leiden University Medical Center Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Casadei","sequence":"additional","affiliation":[{"name":"Department of Surgery Bologna University Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariacristina","family":"Di Marco","sequence":"additional","affiliation":[{"name":"Department of Surgery Bologna University Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael B.","family":"Wallace","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Mayo Clinic Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanne A.","family":"Hoogenboom","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Amsterdam UMC Amsterdam the Netherlands"},{"name":"Department of Gastroenterology & Hepatology Mayo Clinic Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neville","family":"Azopardi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Mater dei Hospital Msida Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reea","family":"Ahola","sequence":"additional","affiliation":[{"name":"Department of Surgery Tampere University Hospital Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcin","family":"Polkowski","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology, and Clinical Oncology Center of Postgraduate Medical Education Warsaw Poland"},{"name":"Department of Oncological Gastroenterology The Maria Sklodowska\u2010Curie National Research Institute of Oncology Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter","family":"Honkoop","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Albert Schweitzer Hospital Dordrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Carrara","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology IRCCS Humanitas Research Hospital Milan Rozzano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik J.","family":"Schoon","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Catharina Hospital Eindhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels G.","family":"Venneman","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Medisch Spectrum Twente Enschede the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurens A.","family":"van der Waaij","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Martini Hospital Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne\u2010Marie","family":"van Berkel","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Noordwest ziekenhuisgroep Alkmaar the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma","family":"Rossi","sequence":"additional","affiliation":[{"name":"Pancreato\u2010Biliary Endoscopy and Endosonography Division Pancreas Translational and Clinical Research Center Milan Italy"},{"name":"San Raffaele Scientific Institute IRCCS Milan Italy"},{"name":"Vita Salute San Raffaele University Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jilling F.","family":"Bergmann","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology HagaZiekenhuis The Hague the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Pando","sequence":"additional","affiliation":[{"name":"Department of Surgery Vall d\u2019Hebron Institute of Research Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Beyer","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Ludwig\u2010Maximilians\u2010University of Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthijs P.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Meander Medical Center Amersfoort the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederike G. I.","family":"van Vilsteren","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology University Medical Center Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantal","family":"Hoge","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Maastricht University Medical Center Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne E.","family":"Smits","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Tergooi Hilversum the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6109-9310","authenticated-orcid":false,"given":"Rutger","family":"Quispel","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Reinier de Graaf Hospital Delft the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellert J.","family":"van Soest","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Spaarne Gasthuis Haarlem the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick M.","family":"Vos","sequence":"additional","affiliation":[{"name":"Department of Radiology St. Pauls Hospital Vancouver the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5591-0499","authenticated-orcid":false,"given":"Robert C.","family":"Verdonk","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Antonius Hospital Nieuwegein the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toon","family":"Steinhauser","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Antwerp University Hospital Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Kouw","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Gelre Hospitals Zutphen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriaan C. I. T. L.","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Canisius Wilhelmina Hospital Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laszlo","family":"Czako","sequence":"additional","affiliation":[{"name":"Center of Gastroenterology Department of Medicine University of Szeged Szeged Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco J.","family":"Bruno","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Erasmus University Medical Center Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Djuna L.","family":"Cahen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology Erasmus University Medical Center Rotterdam the Netherlands"},{"name":"Department of Gastroenterology & Hepatology Amstelland Amstelveen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"PACYFIC\u2010Study Work Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,18]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21820"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102016\u2010313127"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102018\u2010316027"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2023.12.009"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs5.50180"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/xcs.0000000000000176"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010022\u201011326\u20105"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2021.12.001"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.22933"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2017.43"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/14574969221076792"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2020.10.040"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.07.019"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znac103"},{"key":"e_1_2_12_16_1","volume-title":"ECIS \u2010 European Cancer Information System","year":"2024"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.184.1.01840020"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2020.07.028"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.08.032"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2023.7010"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2023.06.022"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000378"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620\u2010015\u20103679\u20108"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i47.13309"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.7168\u201021"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2020.02.013"}],"container-title":["United European Gastroenterology Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ueg2.70043","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T10:39:54Z","timestamp":1753699194000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ueg2.70043"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,18]]},"references-count":25,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1002\/ueg2.70043"],"URL":"https:\/\/doi.org\/10.1002\/ueg2.70043","archive":["Portico"],"relation":{},"ISSN":["2050-6406","2050-6414"],"issn-type":[{"value":"2050-6406","type":"print"},{"value":"2050-6414","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,18]]}}}