Inclusion Criteria:  Affected patient with a family history suggestive of a known hereditary syndrome or meeting NCCN criteria for germline testing and consent to a multicancer panel  --This cohort is meant as a real world control group receiving routine standard of care and is not eligible for WES.  Affected patient with a family history of 5 or more discordant cancers in unilateral descent within a 3-generation pedigree.  Unaffected family members within such kindreds will be eligible for WES as long as a minimum of 2 affected and 1 unaffected family members consent to WES as trial participants.  Exclusion Criteria:  Unable to safely provide a blood sample for genetic testing Unable to receive or decline to receive genetic counselling through the telephone, video conference, or in person Families known to segregate a previously identified high penetrance cancer susceptibility gene identified through routine medical genetics evaluation are not eligible WES Family is not amenable to routine medical genetics SOC genetics evaluation.