When filling out those extensive medical questionnaires or talking with your healthcare provider during routine medical visits, you’re invariably subjected to a battery of questions related to your family health history. Answering this line of questioning with any degree of accuracy can be challenging to say the least. After all, in these hectic times, most of us have a hard enough time remembering what we ate for breakfast, let alone recalling hazy details like what health conditions Great Grandma had and how old she was when she developed them.
However, your doctor isn’t asking these questions to annoy you or trip you up. He or she is looking for valuable insights that can help determine your risk of certain diseases or conditions as well as help guide screening and care planning so you’re less likely to develop the problem in the first place or, if the condition does arise, it’s caught early on when treatment tends to be most effective.
Which details are important?
If possible, your family health history should cover three generations of your family to include parents and grandparents, aunts and uncles, nephews and nieces, siblings, and children. Record details such as any known diseases or conditions (high blood pressure, heart disease, diabetes, cancer, Alzheimer’s, etc.), age of disease onset, and ethnicity. For individuals who have passed away, record the cause of death and age at death.
Also, give special consideration to the following key features identified by the National Institutes of Health:
- Diseases that occur at an earlier age than expected (10 to 20 years before most people get the disease)
- A disease occurring in more than one close relative
- The occurrence of a disease that does not usually affect a certain gender (for example, breast cancer in a male)
- Certain combinations of diseases within a family (for example, breast and ovarian cancer, or heart disease and diabetes).
What can your doctor do with this information?
Your family health history is vital to your doctor for a variety of reasons. The most obvious is that it can be used to help assess your risk of various diseases, including rare disorders and conditions he or she might not otherwise consider. Another is that it can be used to help determine the appropriate type, timing, and frequency of diagnostic/screening tests. For example, the usual recommendation for individuals at normal risk of colorectal cancer is to get their first screening colonoscopy at age 50. However, if one of your parents or siblings had colorectal cancer before age 50, your doctor might recommend that you begin getting screened at a younger age. Similarly, if you’re female and have a family history of breast cancer, e.g. in your mother or sister, your doctor might recommend beginning screening mammograms earlier than normal.
Family health history can also influence doctors’ recommendations with respect to lifestyle habit modifications that can help lower disease risk, referral to different specialists, risk-reducing medications or treatments, genetic testing/counseling for children or siblings, and numerous other aspects of prevention and treatment.
Does family history equal medical destiny?
It’s important to understand that having a family history of a particular disease or condition does not necessarily mean you’re destined to develop it. Many factors beyond genetic predisposition can play a role in disease risk, and in some cases simply adopting a healthier lifestyle—avoiding smoking, eating healthier foods, exercising more, etc.—can reduce your disease risk. In other words, your family health history doesn’t equal your medical destiny. Being armed with this knowledge, and sharing it with your doctor and care team, can help you make the best possible medical and lifestyle choices from the standpoint of prevention.
How should you gather your family health history?
You can try to glean details from family death certificates and other records, but the best way to gather family health information is to have actual conversations with your loved ones. And what better time than Thanksgiving to converse with family members? In fact, Thanksgiving has been designated National Family History Day. You can then compile this information in hardcopy format, or you can store it in electronic format in, for example, My Family Health Portrait, a free, web-based app available at https://phgkb.cdc.gov/FHH/html/index.html.
Whatever format you use, be sure to share your family health history with your family members and healthcare provider, and update it promptly whenever you become aware of a new piece of information.