Assessing Surveillance Practices for Incidental Pancreatic Cystic Lesions in a Rural Community Healthcare Network

Area of Science:

• Gastroenterology
• Oncology
• Radiology

Background:

• Incidental pancreatic cystic lesions (PCLs) are increasingly detected via advanced imaging.
• Certain PCL subtypes, like IPMN and MCN, have malignant potential requiring surveillance.
• Real-world adherence to PCL follow-up guidelines in community settings is not well-defined.

Purpose of the Study:

• To determine surveillance adherence rates for incidentally detected PCLs.
• To identify factors associated with follow-up completion for PCLs.

Main Methods:

• Retrospective, single-center study of adult patients with incidental PCLs (June 2017-January 2024).
• Primary outcome: adherence to follow-up recommendations, defined by completion of repeat imaging.
• Data collected on patient demographics, cyst characteristics, and follow-up completion.

Main Results:

• 98% of 108 patients completed recommended surveillance imaging.
• 87% of patients had gastroenterology follow-up.
• High adherence was associated with having a primary care provider and access to gastroenterology services.

Conclusions:

• Incidental PCL follow-up rates are exceptionally high in this cohort.
• Established primary care and accessible subspecialty gastroenterology services are linked to better adherence.
• Findings support current guideline-directed surveillance for PCLs.