ORIGINAL CONTRIBUTIONS: PANCREAS AND BILIARY TRACTEditorial: Management of the Small Asymptomatic Pancreatic Cyst: Somehow Along the Way We Forgot About the PatientMel Wilcox, C MD, MSPH1 Author Information 1Division of Gastroenterology and Hepatology, Basil I Hirschowitz Endoscopic Center of Excellence, University of Alabama at Birmingham, Birmingham, Alabama, USA Correspondence: C. Mel Wilcox, MD, MSPH, Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, 1720 2nd Avenue, South BDB 380, Birmingham, Alabama 35294-0113, USA. E-mail: [email protected] Received 26 May 2017; accepted 27 May 2017 Guarantor of the article: C. Mel Wilcox, MD, MSPH. Specific author contributions: C. Mel Wilcox wrote the editorial. Financial support: None. Potential competing interests: None. American Journal of Gastroenterology: August 2017 - Volume 112 - Issue 8 - p 1337-1339 doi: 10.1038/ajg.2017.188 Buy Metrics Abstract The incidentally identified pancreatic cyst is an increasing burden for both physicians and patients alike. Although we recognize that most of these lesions are benign and may not progress, a subset of these lesions are premalignant, may have frank cancer, and may progress over time. Most occur in older patients who have associated comorbidity. Recent studies highlight neoplastic features of these cysts that when present may warrant surgery or close long-term follow-up; however, there has been little study on the natural history factoring in patient comorbidity and pancreatic cancer-free survival. This retrospective cohort study underscores the importance of patient comorbidity in our management algorithm, and these data should prompt subsequent guidelines to factor in such comorbidity. © The American College of Gastroenterology 2017. All Rights Reserved.