Roberts ME, Ranola JMO, Marshall ML, et al. - In this review of 75 families found to have pathogenic variants in CDH1 through clinical ascertainment and multigene panel testing at a large commercial diagnostic laboratory from August 5, 2013, to June 30, 2018, experts estimated CDH1 penetrance in a patient cohort not solely discovered on the basis of on strict hereditary diffuse gastric cancer (HDGC) criteria. Ethnicity was listed for 67 of 75 families and of these 67 families, 51 inscribed European ancestry, whereas Asian, African, Latino, and two or more ancestries were listed for four families each. Standardized incidence ratios for gastric and breast cancer were significantly raised above Surveillance, Epidemiology, and End Results incidence. Extrapolated cumulative incidence of gastric cancer at age 80 years was 42% and 33% for men and for women, respectively, with pathogenic variants in CDH1, whereas the cumulative incidence of female breast cancer was estimated at 55%. In 25 of the 75 families, International Gastric Cancer Linkage Consortium criteria were met, nevertheless, dispensing with the necessity of confirmation of HDGC histologic subtype, 43 would meet criteria. Therefore, for individuals with pathogenic variants in CDH1, the cumulative incidence of gastric cancer is significantly lower than formerly reported. As prophylactic gastrectomy can have a bearing upon both physical and psychological health, additional discussion is guaranteed to evaluate whether this surgical recommendation is relevant for all individuals with pathogenic variants in CDH1.