To the Editor In their recent multicenter cohort study published in JAMA Oncology, Samadder et al1 found that 13.3% (397 of 2984) of patients diagnosed with cancer harbored a pathogenic germline variant (PGV) and that 71.0% (282 of 397) of these PGVs were either high or moderate penetrance. They report that treatment decisions were commonly based on those discovered PGVs.