When it comes to pancreatic cancer, early detection makes all the difference. Sadly, this disease often isn’t diagnosed until later stages. In fact, upwards of 80% of pancreatic cancer cases are either not resectable or metastatic at the time of diagnosis. Therefore, mitigating factors are exceedingly important.

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It is well known that mucinous pancreatic cysts are the most common identifiable precursor to pancreatic cancer, making identification and surveillance strategies necessary.

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Why Pancreatic Cysts Are Game-Changers

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Mucinous pancreatic cysts are mostly found “incidentally” or discovered during imaging performed for unrelated reasons. Despite their potential to transform the pancreatic cancer narrative, these cysts often go unnoticed or unmanaged due to a knowledge gap as well as the lack of standardized screening programs and guidelines.

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As a surgical oncologist, it’s heartbreaking to meet patients with late-stage pancreatic cancer—especially when a cyst identified earlier could have led to life-saving treatment. Many of these patients have unknowingly been living with significant pancreatic cancer risk, and by the time they’re diagnosed, it’s often too late to offer real chances of cure.

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Unlike cancers such as breast, lung, or colon, which have well-established screening protocols, pancreatic cysts are stuck in a gray area. There’s no universal agreement on how to screen for or monitor them, leaving many patients at risk and physicians unsure of what to do. In my view, patients with pancreatic cysts are in a similar situation to those with incidental pulmonary nodules: they’re at a higher risk for the development of cancer and need careful, evidence-based, life-long management.

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Since it has been well documented that mucinous pancreatic cysts have the potential to transform into pancreas cancer, these patients need to be properly identified and moved into appropriate surveillance in order to risk stratify and intervene prior to the development of cancer.

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Transforming Care with Modern Surveillance Programs

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Cooperman Barnabas Medical Center, part of RWJBarnabas Health, partnered with Eon to develop an AI-driven pancreatic cyst surveillance program. The Eon technology automates the identification and tracking of pancreatic abnormalities, ensuring patients are followed longitudinally and receive evidence-based care.

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For example, if a radiologist reports a 2 cm pancreatic cyst on a scan of the abdomen, that patient will be automatically contacted, the physician who ordered the scan will be contacted, and the patient offered a consultation with our surveillance program. Additionally, once the patient is in the program, the AI component of the software assists in risk assessment and longitudinal surveillance to ensure patients are followed up appropriately.

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The program’s impact has been significant:

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• In just two years, the program grew by 375%, identifying 500+ patients with pancreatic cyst abnormalities.
• Of those patients, 16.7% were deemed high-risk, with cysts measuring greater than 3 cm.
• Managing these patients led to 1,300 follow-up procedures, like MRIs and endoscopic ultrasounds, helping us stay ahead of potential issues.

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In my experience, about 5 to 10% of these patients will eventually need pancreatic surgery as risk reduction for pancreas cancer. Thanks to Eon’s technology, we’re catching cases that might have otherwise slipped through the cracks (e.g. formed pancreas cancer).

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Early results of the program also indicate that Eon accurately identified new pancreas and possibly peri-pancreatic cancers, of which 55% were caught in earlier stages (I-III), compared to the national average of only 20%. This may allow for faster time-to-treatment and greater access to curative interventions.

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Changing the National Conversation

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It’s clear to me that we need to push for national change. The evidence is overwhelming: mucinous pancreatic cysts are an early warning sign of cancer, and we must do more to educate the medical community on the importance of detecting and managing them.

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Programs like ours, powered by intelligent technology, have the potential to revolutionize pancreatic cancer care. By catching cancer earlier, we can save countless lives. Our surveillance program at RWJBarnabas sets a new standard for managing pancreatic cysts—making early detection the rule, not the exception.

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For providers, surgeons, and care teams, adopting surveillance strategies can enable previously-impossible early intervention, improved survival rates, and a business case for programmatic growth. These cysts may seem incidental, but their ability to save lives is nothing short of extraordinary. By prioritizing their detection and management, we’re offering patients something invaluable: hope for a cancer-free future.

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