Hence, many individuals remain undiagnosed, resulting in underestimated prevalence.2 A recent study evaluated the prevalence of PHTS in two large research cohorts, suggesting that PHTS may be 10–20 times more common than earlier estimates.13, 14 Relatedly, studies characterizing PTEN genotype and PHTS-related phenotypes have focused on subsets of individuals from specialized centers, such as our PTEN Multidisciplinary Clinic and Center of Excellence at the Cleveland Clinic, or centers focused on cancer care. This evidence concerns the gene PTEN and cancer.