The American Gastroenterological Association (AGA) has released new guidelines on the management of asymptomatic neoplastic pancreatic cysts found incidentally during computed tomography (CT) or magnetic resonance imaging (MRI). The author of a commentary being published in Annals of Internal Medicine explains how the AGA's bold new recommendations will affect the way physicians consider diagnostic testing. The new guidelines back away from previous recommendations that were more aggressive.

Rather than promote invasive work-up, surveillance, or surgery for typical patients, the AGA guidelines restrict aggressive follow up to patients with more high-risk features. The author suggests that learning to use restraint with medical tests could help to minimize harms and costs while preserving benefit.

Article: Incidental Findings in the Pancreas (and Elsewhere): Putting Our Patients (and Ourselves) in a Difficult Situation, Russell P. Harris, MD, MPH, Annals of Internal Medicine, doi:10.7326/M15-0590, published online 25 March 2015.