Sometimes it really is all in the genes. Knowing your family's medical history can alert you to potential problems and help you take precautionary measures. As researchers discover new genetic markers, certain individuals and families may be identified as having a higher than average risk for a variety of diseases. When it comes to your health, the apple does not fall far from the tree. Knowing your family medical history may save your life or the lives of your children and grandchildren.
Certain types of cancers run in families. Sometimes it's because the family members have common risk factors, but in some cases it's because the family members share a genetic trait that is being passed down through the generations. Some cancers that are linked to family history include breast, ovarian, prostate, and colon cancer.
Conditions like heart disease, stroke, asthma, diabetes, arthritis, and Alzheimer's also tend to run in families. You will not necessarily be affected just because someone else in your family was, but under certain circumstances your risk might be increased. Inherited risk involves complex interactions among several genes and your environment. Your behaviors—smoking, weight management, dealing with stress, heavy drinking, exposure to toxins—influence whether you'll get a disease.
Your family medical history is valuable to you and to future generations of your family. Medical histories for your first-degree relatives are most important. First-degree relatives include:
You probably already know a lot of your family medical history. For the rest, talk to relatives. If you explain the good deed you are doing for the whole family, they may be more open to discussing dates of diagnoses and causes of death. Death certificates are available at your county records department for a reasonable cost. To request a medical record from a hospital or doctor, you must have written permission from the person whose record you want. If they are deceased, you must get written permission from the closest living relative.
Researching your family medical history is like genealogy. You can keep it simple or get completely carried away. Consider including the following information:
If you can, collect the same information about your second-degree relatives:
As you build your family medical tree, remember these tips:
Be as specific as possible about cause of death and major illnesses. Knowing grandpa had cancer is a start. But what kind of cancer? At what age was he diagnosed? Did he develop a second cancer? Was it related to the first? Be wary of the cancer spread trap. Many cancers start in one organ but spread to another, often the brain, liver, lung, or bone. If you conclude that your relative had lung cancer when she really died of ovarian cancer that had spread to the lung, you will likely have misleading family history information. Unfortunately, sometimes it is hard or impossible to find out the true origins of a cancer.
Take it a step further if you would like. Include significant habits and any unusual physical characteristics. Grandma Nelson's dowager's hump may mean her daughter and granddaughter are at risk for osteoporosis. Uncle Fester's three-pack-a-day habit—not heredity—may be why he died of cancer.
If you are artistic, draw a family medical tree. On the bottom of the tree, put your name, along with your sisters and brothers. On the row above, put your parents and their brothers and sisters. On the top row, put your grandparents. Put a square around each man and a circle around each woman. Leave enough room in each to summarize the information you've collected. Indicate marriages by connecting with lines.
Here are a few general guidelines for interpreting the medical information of your relatives:
If you suspect you are at risk for a disease, show your doctor your family medical history. Your doctor may suggest you undergo screening exams sooner than is normally recommended.
Your doctor may refer you to a genetic counselor. Genetic counselors can talk to you about genetic testing and about banking your DNA.
You can collect your DNA and save it for testing at a later date. Genetic tests are already available for many inherited diseases. Even if there is not a genetic test for your disease, there may be one in the future. Your sample may save the life of your grandchildren or great-grandchildren.
Banking your DNA is easy. You can purchase a kit and collect and store the samples yourself. You can store these samples in envelopes wherever you keep important documents. Or, you can deposit your sample with a commercial gene bank—for a fee—for indefinite storage.
Genetic testing is a complex matter. It does not offer 100% predictability. It may give you a peace of mind, but it also can be a source of significant anxiety for some people. Before deciding, weigh all the benefits and risks, and talk to your doctor or a genetic counselor. Ultimately, you have the final decision.
My Family Health Portrait, United States Department of Health and Human Services
National Human Genome Research Institute
Public Health Agency of Canada
Accessing deceased patient records—FAQ. Journal of AHIMA website. Available at: http://journal.ahima.org/2011/03/23/accessing-deceased-patient-health-records-faq/. Published March 23, 2011. Accessed March 7, 2013.
Alzheimer's disease genetics fact sheet. National Institute on Aging website. Available at: http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-genetics-fact-sheet. Updated April 9, 2012. Accessed March 7, 2013.
Beery TA, Williams JK Risk reduction and health promotion behaviors following genetic testing for adult-onset disorders. Genet Test. 2007;11:111-123.
DNA banking. Genetics Home Reference website. Available at: http://ghr.nlm.nih.gov/glossary=dnabanking. Published March 4, 2013. Accessed March 7, 2013.
Family history and heart disease, stroke. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Family-History-and-Heart-Disease-Stroke_UCM_442849_Article.jsp. Updated February 12, 2013. Accessed March 7, 2013.
Heredity and arthritis. American College of Rheumatology website. Available at: http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/heredity.asp. Updated February 2012. Accessed March 7, 2013.
Heredity and cancer. American Cancer Society website. Available at: http://www.cancer.org/cancer/cancercauses/geneticsandcancer/heredity-and-cancer. Updated January 25, 2013. Accessed March 7, 2013.
Inheriting genetic conditions. Genetics Home Reference website. Available at: http://ghr.nlm.nih.gov/handbook/inheritance?show=all#riskassessment. Published March 4, 2013. Accessed March 7, 2013.
Is asthma inherited? Partners Healthcare website. Available at: http://www.asthma.partners.org/newfiles/BoFAChapter34.html. Accessed March 7, 2013.
Know your family medical tree. The Ohio State University website. Available at: http://shs.osu.edu/articles/national-roots-branches-month-know-your-family-medical-tree/. Accessed March 7, 2013.
Where to write for vital records. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/nchs/w2w.htm. Updated June 27, 2012. Accessed March 7, 2013.
Wolf SM, Kahn JP; Working Group on Genetic Testing in Disability Insurance. Genetic testing and the future of disability insurance: ethics, law & policy [review]. J Law Med Ethics. 2007;35(suppl 2):6-32.
Your medical records. US Department of Health and Human Services website. Available at: http://www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/medicalrecords.html. Accessed March 7, 2013.
Last reviewed March 2013 by Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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