Do you ever wonder why your doctor asks about your family health history? That is, whether your siblings, parents, grandparents or other close relatives have (or had) diabetes, high blood pressure, certain cancers or other medical conditions?
What difference does it make, you may reason, if your parents have high blood pressure or your grandmother had breast cancer? Or, if your dad had colon cancer — or your brother diabetes? That’s them — not you.
Right?
In a word — no.
The thing is, whether we like it or not, we’re all products of our families. We inherit half of our genetic profile or makeup from each parent. Genes determine traits like our height, hair and eye color. They’re the reason we’re short or tall, have blue, green, gray or brown eyes, are blondes, redheads or brunettes.
But looks aren’t all we inherit. We also inherit genes that may cause or increase the risk of developing certain health conditions.
A family medical history can reveal the history of disease in your family — and provide a window into some of your potential health risks and patterns relevant to your present and future health.
It arms your doctor with information that may help determine the best way to care for you, including your need for additional testing, the frequency of screening procedures and how often you should see your healthcare provider.
Family health in the history books
A quick look back shows us the potentially far-reaching effects of the health of past generations on future ones.
One glaring example: the prevalence of hemophilia among the royal houses of Europe in the 19 and 20th centuries.
Hemophilia is a rare condition in which a person’s blood doesn’t clot properly — a tiny nick could be deadly. Evidence points to Queen Victoria of England (who reigned from 1837 until her death in 1901) as the source of the gene mutation or glitch that causes this disorder. Several of her children were carriers and her son, Prince Leopold, Duke of Albany, suffered from the disease, leading to it once being dubbed “the royal disease.” It’s believed Victoria also spread hemophilia (through her children) to other royal families across the continent (including those of Spain and Germany).
At the time, it was common for royals to marry close relatives. The fact that both parents might be carriers of this faulty gene dramatically increased the chances of it being passed on to their children and their children’s children and so on.
Genetic testing
Science now allows us to identify numerous genes that may be passed on and lead to certain diseases.
Early detection is often key to treatment. Many states now mandate newborn screening. The amount varies depending on the state, but nearly all now screen for more than 30 disorders.
Unfortunately, not all genetic conditions can be treated. But knowing one exists can provide proper care at an early stage — and make a difference in health outcomes and quality of life.
Genetic testing can also inform decisions about having children and future pregnancies.
For example, knowing you have a sickle-cell anemia trait alerts you that you could pass it on to your child. If your partner is also a carrier, you know that any child you have together has a greater chance of developing the disease.
In families at heightened risk, fetuses can be checked for several genetic disorders (with amniocentesis and other tests) before an expectant mom gives birth.
Unfortunately, genetic mutations can be spontaneous. That means parents may not know they’re carriers until their child is diagnosed with a disorder. It may take years to correctly diagnose a condition — after they’ve already had more children at risk.
Some of the best examples of how family history is used is in cancer care. Besides genetic testing, knowing your family history of certain cancers can help determine your risk and when you should begin getting recommended screenings.
For instance, experts recommend those at average risk begin colon cancer screening (with a procedure such as colonoscopy) at age 50. But they recommend beginning earlier, perhaps at age 40 or younger, if there’s a strong family history, especially in so-called first-degree relatives (parents or siblings).
This risk-related approach also applies to hereditary breast cancer. For example, a woman might begin breast cancer screening in her 20s (or younger) if her mother was diagnosed at a young age.
What you can do
When the opportunity presents itself, ask your parents, grandparents, aunts and uncles about illnesses common in your family. Explain that the information they share will help you create a family health portrait that could benefit the entire family. Some family members may be reluctant to share all or parts of their health information. Be sensitive to their feelings and let them know that any information they provide will be helpful.
This advice is especially timely as we head into the holiday season. The holidays present a great opportunity to learn more about your family health history. I encourage you to talk about and record health problems that seem to run in your family — and pass them on to your own children when the time is right.
Keep these points in mind the next time your doctor asks about your family medical history. I assure you that taking a few minutes to share it will be time well spent.
It may mean getting a mammogram or colonoscopy earlier if you have relatives who developed breast or colorectal cancers at a young age. Or, if you have a strong family history of heart disease, making lifestyle choices that may cut your risk, such as not smoking (or quitting), shaving excess weight, exercising regularly, and eating healthier.
The bottom line: Explore your family health roots — and share them with your doctor. Don’t be afraid of what your might discover. Knowledge is power. Unraveling your medical history can uncover obstacles you may face. But it can also reveal steps you can take to help overcome them so that you (and your children) can have a healthier, longer life.