An accurate and up-to-date family medical history is one of the most important tools you have for safeguarding your health.
It provides a roadmap to your own genetic strengths and weaknesses, pinpointing the ailments for which you need frequent screening tests and an aggressive prevention plan.
Here are the answers to some frequently asked questions about why you need to know your family medical history…
- If I have a healthful lifestyle, do I still need to learn my family medical history? Absolutely. Most diseases have an environmental and genetic component. For example, coronary artery disease is caused primarily by a diet high in animal and dairy fat. But genetic factors help determine your vulnerability.
Likewise, your risk for lung cancer or emphysema depends on your smoking habits and on your genetic susceptibility to the effects of smoking.
Knowing your family medical history allows you and your doctor to monitor for symptoms and alter your lifestyle so that you can drastically reduce your chances of developing any of these diseases.
Thousands of rare diseases, such as cystic fibrosis and hemophilia, are entirely hereditary. If one of these diseases happens to run in your family, you may want to consider getting genetic testing
- Isn't it my doctor's responsibility to ask about my family medical history? Your doctor should ask about your family medical history during your first visit. However, completing this history is a cooperative effort, requiring your active input.
Your doctor needs to know about any medical condition affecting your first-degree relatives. This includes parents, siblings and grandparents.
Tell your doctor if any first-or second-degree relative (grandparent, aunt or uncle) suffered from inherited diseases, such as sickle cell anemia...cystic fibrosis... Marfan syndrome (a connective tissue disorder)...hemophilia...Parkinson's disease...or muscular dystrophy.
- What other things do I need to know about the medical conditions that have affected my relatives? The age when a disease first strikes can be extremely important, because it may indicate your family's level of genetic vulnerability. Heart attack, stroke, bypass surgery or angioplasty in a first-degree male relative under age 45 or in a female relative under age 55 may indicate strong genetic susceptibility.
The age when high blood pressure, diabetes or cancer strikes is also significant. The earlier these conditions appear, the more likely a genetic risk factor is involved.
- Will my family medical history tell me anything other than possible lifestyle changes I should make? Your family history can also indicate when early screening is warranted to detect diseases in their early stages when they're most treatable.
- If you have a first-degree relative with hypertension, you should get annual blood pressure checks starting at age 18.
- If you have a first-degree relative with heart disease or high cholesterol, you should start cholesterol testing in your mid-teens and continue on a schedule recommended by your doctor.
- If breast, ovarian or colon cancer has occurred in three or more relatives (or two relatives, including one under age 40), you should get mammograms (for breast cancer), CA-125 blood tests (for ovarian cancer) and colonoscopies (for colon cancer) beginning at age 40, or at the earliest age of diagnosis in the family, if under age 40.
If you are male and your father, uncle or brother had prostate cancer, you should consider annual examinations and prostate-specific antigen (PSA) testing starting at age 45.
- If my family history suggests a specific genetic vulnerability, should I undergo genetic testing? Most genetic vulnerabilities have not yet been traced to specific gene mutations, so they can't be tested for. Even with diseases such as polycystic kidney disease and Marfan syndrome, which are linked to specific mutations, the case for testing isn't always clear.
In families that have a history of breast cancer, which has been linked to two specific gene mutations (BRCA1 and BRCA2), testing is probably a good idea. If you turn out to have one or both mutations, then you can be extra vigilant about breast self-examinations and mammograms.
One of the major advantages of genetic testing for cancer susceptibility is that it identifies those who may benefit from earlier and more frequent monitoring than is recommended for the general public.
Testing also identifies those who did not inherit their family's mutation and do not need to undergo more intensive monitoring.
With inherited diseases, such as sickle cell anemia, it makes sense to test the extended family (aunts, uncles, cousins, nieces and nephews) as well as the immediate family to identify the carriers for the gene mutation meaning they could pass the mutation to their own children).
