We have performed optional screening tests for the detection of pancreatic and biliary duct lesions since 2010 at Itoigawa General Hospital in Niigata, Japan. Here, we report the test results over a 10-year period. In total, 79 participants (51 male, 65%; mean age, 64 years) were screened. Fifteen participants were positive for antinuclear antibodies. Elevated serum IgG4 was found in 1 participant. None had positive antimitochondrial antibody. On magnetic resonance cholangiopancreatography, there was no evidence of pancreatic and biliary duct autoimmune disorders or cancer, but we suspected branch-duct intraductal papillary mucinous neoplasia in 1 participant. Because of potential selection bias in the characteristics of the participants who choose to undergo screening, an important question is how to identify those who might have malignancy and should undergo more sensitive imaging examinations. Performing antibody tests for biliary autoimmune diseases needs to be reconsidered.