# Perceived factors influencing patient acceptance of reduced surveillance of low-risk pancreatic cysts – A Dutch focus group study

## TL;DR

This study explores why patients may resist less frequent monitoring for low-risk pancreatic cysts, highlighting the role of reassurance and knowledge gaps.

## Contribution

The study identifies modifiable barriers and facilitators to accepting reduced surveillance for low-risk pancreatic cysts using patient perspectives.

## Key findings

- Loss of reassurance is a key barrier to accepting reduced surveillance.
- Clear evidence of safety improves patient acceptance of less frequent monitoring.
- Personal or social experience with pancreatic cancer increases resistance to reduced surveillance.

## Abstract

This study aimed to explore how patients perceive less intensive surveillance recommendations for low-risk pancreatic cysts.

Three semi-structured focus groups with individuals undergoing surveillance for low-risk pancreatic cysts were conducted. Results were thematically analyzed and structured according to the health-belief model, which addresses adoption of health behaviors.

Sixteen Dutch individuals participated, including eight females. The median age was 68 years (range 42–77).

Several knowledge gaps emerged as modifiable barriers to acceptance of reduced surveillance, including limited understanding of pancreatic cancer (PaC) risks, cyst prevalence, cyst-related symptoms, and PaC treatment. Many expressed concerns regarding losing reassurance, with some considering self-organized follow-ups. PaC among family or social circles considerably contributed to reluctance in accepting limited surveillance. Conversely, evidence supporting the safety of less surveillance appeared a strong facilitator. Participants were more willing when their cyst remained stable, because they perceived themselves as low risk. Trust in the medical profession and adequate information provision supported acceptance.

Loss of reassurance was a key barrier to accepting reduced surveillance. Addressing knowledge gaps and providing clear evidence of its safety considerably improved acceptance. These insights can help physicians counsel patients more effectively to improve patient acceptance and facilitate implementation of less rigorous guidelines.

•Loss of potential reassurance was a key barrier to reduced cyst surveillance.•Knowledge gaps about cysts and pancreatic cancer appeared modifiable barriers.•Clear evidence supporting safety of less surveillance appeared a strong facilitator.•Experience with pancreatic cancer heighted resistance to reduced surveillance.

Loss of potential reassurance was a key barrier to reduced cyst surveillance.

Knowledge gaps about cysts and pancreatic cancer appeared modifiable barriers.

Clear evidence supporting safety of less surveillance appeared a strong facilitator.

Experience with pancreatic cancer heighted resistance to reduced surveillance.