Some inherited illnesses are easy to detect. Newborns are screened for sickle cell disease now in all states. But other inherited illnesses lurk in the background and can strike with little or no warning.
That is why the Surgeon General in 2004 launched a Family History Initiative to encourage families to learn more about their inherited health risks. The Surgeon General designated Thanksgiving — a holiday when families gather — as National Family History Day. The Department of Health and Human Services has created a web-based tool at familyhistory.hhs.gov that allows users to enter, print out and save the information.
The value of family medical histories is enormous, largely because several illnesses are passed down from generation to generation. Many diseases, such as cancer, diabetes, high blood pressure and even mental illness, have a genetic link.
The family history tree is an essential tool for patient empowerment. It allows a doctor to assess risks for a certain disease, determine the type and time of screening tests and judge the risk of passing the conditions on to the next generation.
For instance, women who have a history of breast cancer — especially when diagnosed at a young age — may require initiation of mammograms before the age of 40 as well as a concomitant MRI.
“The biggest concerns are cancer and heart disease, especially in the young,” said Dr. Mark Drews, an internist at Whittier Street Health Center. “If you’re 40 and your brother died of cancer at 40, you should know which cancer. If it was prostate cancer, you need to start screening now. If it was lung cancer and he was a heavy smoker, there is less concern.”
An ideal family history includes at least three generations. Primary relatives — parents, children and siblings — are most important. But grandparents, aunts, uncles and cousins should not be overlooked.
What should trigger attention is a disease that occurs at an earlier age than expected, a disease in more than one close relative, a disease that is atypical for that gender — for instance breast cancer in a male — and certain combinations of diseases, such as breast and ovarian cancer.
It takes a bit of detective work to complete the history. Ask questions, review death certificates and available medical records. Determine age of diagnosis and age and cause of death. List ethnic backgrounds as well.
The history is a work in progress and should be corrected and edited as new information comes to light. Most important is to pay attention to what’s been revealed.
Lifestyle changes — healthy diet, exercise, and smoking cessation — will not change your genes, but can reduce the risk of the diseases. The fact that your family has a certain history is not a guarantee that you will likewise be afflicted.
The key is to start building the tree now to get an idea of what could be hidden in your genetic makeup.
