This update offers critical insights on discontinuing surveillance for pancreatic cystic lesions (PCLs) and hepatocellular carcinoma (HCC) in older adults, emphasizing a tailored approach based on individual risk.

• Patients over 65 with stable PCLs ≤15 mm for 5 years should consider ending routine surveillance following thorough discussion, as risky interventions may outweigh benefits.
• In those >75 with stable PCLs <30 mm, discussions on the minimal risk of cancer may lead to surveillance cessation after 5 years if they understand the context.
• HCC surveillance in seniors with cirrhosis should not be age-based alone but rather consider life expectancy and comorbidity, with cessation recommended if life expectancy is less than 1–2 years.

Surgeons should integrate these guidelines into decision-making discussions to optimize patient outcomes.