Sprij Marloes L J A, de Kok Inge M C M, Nieboer Daan D, Capurso Gabriele, Meziani Jihane, Wielenga Mattheus C B, van der Ende Mirjam C M, Smits Marianne E, Casadei Riccardo, Schwartz Matthijs P, van Vilsteren Frederike G I, Hoge Chantal, Quispel Rutger, Honkoop Pieter, van der Waaij Laurens A, Rossi Gemma, Tan Adriaan C I T L, Bruno Marco J, Cahen Djuna L
Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
Med Decis Making. 2025 Oct;45(7):904-912. doi: 10.1177/0272989X251352750. Epub 2025 Aug 3.
BackgroundRecent 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.MethodsThis 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.ResultsOf the 215 participants included from the Netherlands ( = 185) and Italy ( = 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.ConclusionMost 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.HighlightsMost low-risk individuals were reluctant toward less frequent pancreatic cyst surveillance.Older age and residency in Italy were associated with a higher willingness.A medical history of cancer was associated with an unwillingness.Standardized patient information may increase the willingness, but such information has yet to be developed.
背景
近期研究表明，低风险胰腺囊肿可能需要减少监测频率。未来的指南可能会相应调整其建议。我们的目标是探讨低风险胰腺囊肿患者接受较低频率监测的意愿，并确定与此意愿相关的特征。
方法
这是国际PACIFIC研究的一项辅助研究，该研究前瞻性收集囊肿监测数据，包括评估参与者对监测态度的问卷。纳入基线时患有低风险囊肿且未按研究方案给予标准化信息的个体。使用多变量逻辑回归将他们对基线问题“你是否希望减少监测频率？是/否”的回答与基线特征相关联，这些特征包括年龄、居住国家、症状、病史和家族史、首次发现囊肿后的时间以及医院焦虑抑郁量表评分。
结果
在纳入的215名来自荷兰（n = 185）和意大利（n = 30）的参与者中，只有47名（22%）愿意接受较少的监测。与这种意愿呈正相关的特征是年龄较大（每10岁优势比[OR] 1.87，95%置信区间[CI]：1.15 - 3.04）和居住在意大利（OR 16.35，95% CI：5.65 - 47.31）。癌症病史与之呈负相关（OR 0.28，95% CI：0.09 - 0.90）。未观察到其他关联。
结论
大多数参与者似乎不愿意接受较低频率的囊肿监测。年龄较大和居住在意大利与更愿意接受不那么严格的监测相关，而癌症病史则相反。确定哪些个体对接受较低频率监测犹豫不决可能有助于临床医生调整他们的咨询，并支持未来减少监测建议的指南的实施。
要点
大多数低风险个体不愿意接受较低频率的胰腺囊肿监测。
年龄较大和居住在意大利与更高的意愿相关。
癌症病史与不愿意相关。
标准化的患者信息可能会增加意愿，但此类信息尚未制定。
