我们的目的是更好地了解患者的治疗偏好，并量化治疗偏好改变时的癌症风险水平（风险阈值），以便为导管内乳头状粘液性肿瘤 (IPMN) 患者提供更好的咨询。IPMN 管理的复杂性提供了一个调整的机会我们调查了一组健康志愿者样本，模拟了一个常见场景：进行一项成像研究，结果偶然发现了 IPMN。在这种情况下，IPMN 中癌症的估计风险为 5%。询问患者的治疗偏好（手术或监测），以量化 IPMN 中他们的治疗偏好发生变化的癌症风险水平（即风险阈值），以及采用 5 点李克特量表测量的癌症焦虑水平。我们使用多变量线性回归检查了参与者特征、治疗偏好和风险阈值之间的关联。520 名参与者的中位风险阈值为 25% (IQR 2.3-50%)。风险阈值呈双峰分布：40% 的参与者的风险阈值在 0-10% 之间，47% 的参与者的风险阈值高于 30%。当得知患癌症的风险为 5% 时，62% 的参与者 (n=323) 选择进行监测，其余 38% (n=197) 选择手术。在调整潜在的混杂因素后，对 IPMN 恶性肿瘤风险表示“担心”或“极度担心”的参与者的风险阈值显着低于“完全不担心”的参与者（系数 -12，95%CI -21 至 - 2，P=0.015，系数分别为-18，95%CI -29至-8，P<0.001）。参与者的治疗偏好和偶然发现的IPMN的风险阈值各不相同。鉴于估计 IPMN 真正恶性潜力的不确定性，更好地了解患者的风险阈值（受患者对恶性肿瘤的担忧的影响）将有助于为共同决策过程提供信息。版权所有 © 2024 Wolters Kluwer Health, Inc. 所有权利预订的。

We aimed to better understand patients' treatment preferences and quantify the level of cancer risk at which treatment preferences change (risk threshold) to inform better counseling of patients with intraductal papillary mucinous neoplasms (IPMNs).The complexity of IPMN management provides an opportunity to align treatment with individual preference.We surveyed a sample of healthy volunteers simulating a common scenario: undergoing an imaging study that incidentally identifies an IPMN. In the scenario, the estimated risk of cancer in the IPMN was 5%. Patients were asked their treatment preference (surgery or surveillance), to quantify the level of cancer risk in the IPMN at which their treatment preference would change (i.e. risk threshold), and their level of cancer anxiety as measured on a 5-point Likert scale. We examined associations between participant characteristics, treatment preferences, and risk threshold using multivariable linear regression.The median risk threshold among the 520 participants was 25% (IQR 2.3-50%). The risk threshold had a bimodal distribution: 40% of participants had a risk threshold between 0-10% and 47% had a risk threshold above 30%. When informed that the risk of cancer was 5%, 62% of participants (n=323) preferred surveillance, and the remaining 38% (n=197) preferred surgery. After adjusting for potential confounders, participants who expressed "worry" or "extreme worry" about the malignancy risk of IPMN had significantly lower risk thresholds than participants who were "not at all worried" (Coefficient -12, 95%CI -21 to -2, P=0.015 and Coefficient -18, 95%CI -29 to -8, P<0.001, respectively).Participants varied in treatment preference and risk threshold of incidentally identified IPMNs. Given the uncertainty in estimating the true malignant potential of IPMNs, a better understanding of a patient's risk threshold, as influenced by patient concern about malignancy, will help inform the shared decision-making process.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.