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We are grateful that the results of our international collaboration solicited debate concerning such a compelling dilemma.1 We proposed that discontinuing surveillance for seniors with presumed branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) < 30 mm and no clinical–radiologic signs of concern after 5 years of observation can be a safe option because the likelihood of developing pancreatic cancer after that equals the risk of the general, age-stratified population. For those harboring smaller cysts (<15 mm), a similar approach might apply to those aged 65 years.

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