A gene-based test can distinguish precancerous pancreatic cysts from harmless ones and may eventually help patients avoid unneeded and potentially risky surgery. “There has long been a need for accurate, quantitative ways to identify cysts that are more worrisome and to help patients avoid unnecessary surgeries for harmless cysts,” says Bert Vogelstein, professor of oncology and pathology at Johns Hopkins University. Fluid-filled cysts are identified each year in more than a million patients, most of whom have undergone CT or MRI scans to evaluate non-specific symptoms, such as abdominal pain and swelling.