First, our risk score is based on a cohort enriched with familial, young-onset patients and GH-excess tumours as the number of AIP mutated patients in unselected cohorts is low.9 37 Although all possible diagnostic groups have some representation in our study, caution should be taken when extrapolating these results to a population with significantly different prevalence of AIP mutations than the one found in our cohort; this score ideally estimates the risk in patients where the mutation is already suspected. The gene discussed is AIP; the disease is neoplasm.