Study shows that evolving management of IPMNs affects cancer detection and surgical decisions.

• Surveillance for IPMNs rose significantly, with 74% of 3,304 patients managed this way.
• Rates of high-grade dysplasia and invasive carcinoma increased after surveillance, with high-risk stigmata rising from 9% to 48%.

Timely surgical intervention is crucial, as delayed resections may lead to worse outcomes.

• Overall, low-grade dysplasia decreased, but invasive cancer remains a concern, highlighting the need for better monitoring and intervention strategies.