The international consensus guidelines on surveillance of pancreatic cancer in chronic pancreatitis do not recommend screening for patients with SPINK1 p. N34S or with other germline mutations including those of CFTR, CTRC, CPA1, and CEL based on the rationale that PDAC risk in this subpopulation is not high enough to support annual surveillance [118]. This evidence concerns the gene SPINK1 and chronic pancreatitis.