The Medical Minute: Family medical history, a genetic picture

November 24, 2004

By John Messmer
Penn State Milton S. Hershey Medical Center
Penn State College of Medicine

Consider family history. Individuals probably recall what occupations their parents and grandparents held and whether anyone was famous. They might realize that they and their children share qualities with many relatives. Talents and skills such as artistic or mathematical abilities often are passed on from parent to child just as curly hair and dimples. But family history is much more than just names and dates. Because everyone shares genetic background with relatives, physicians rely on family histories to look for health characteristics that can be passed down just like talents and hair color. Family health history can be an invaluable aid to help physicians in maintaining their patients' health.

This year the surgeon general has designated Thanksgiving Day as the first National Family History Day. Traditionally, families gather on Thanksgiving, making this an ideal time to discuss details of family medical history. Take this opportunity to discuss members of the family, living and dead, and what medical problems they had, how they died and at what ages. Look at death certificates and old medical records if available. People who are adopted often can contact adoption agencies to obtain medical histories on their parents even if identities are to be kept confidential.

It is particularly important to note family members who developed diseases 10 to 20 years earlier than expected or if two or more close relatives had the same disease. Disease that does not usually affect one gender, such as breast cancer in a male or heart disease in a premenopausal woman is noteworthy. Combinations of related problems as breast and ovarian cancer or heart disease and diabetes also are important.

Ethnic background is pertinent as some problems are more common in certain groups. Common ethnic associations include sickle-cell anemia in African-Americans, Tay-Sacks disease in Ashkenazi Jews, thalassemia in those with ancestry in Mediterranean basin countries, diabetes in certain Native-American tribes, iron storage problems in some northern European groups.

It is particularly useful to identify diseases with serious consequences for which early diagnosis and treatment is beneficial and which can be prevented with planning. Cancer, heart disease, diabetes, asthma, osteoporosis, mental illness, high blood pressure, stroke, kidney disease, alcoholism and other substance abuse, birth defects, learning disabilities, and early vision or hearing loss are problems that can be screened for and treated or prevented if a physician knows they are prevalent in a family. Sometimes a diagnosis can be made much earlier, before damage is done.

If a physician knows that several family members have diabetes, for example, it would be prudent to screen for it early and to help individuals in that family manage their own risks that increase the chance of diabetes, such as obesity or lack of exercise. Knowing someone had colon cancer at an early age could prompt an early colonoscopy before age 50, the usual age for first screening. If your family has early heart disease, early prevention can be more aggressive to reduce your own risk.

To begin, individuals should write down family members starting with themselves, their parents, brothers and sisters. With each parent, list their siblings and parents and continue for each preceding generation. These names can be assembled into a tree diagram with you at the base. Note the countries your family members came from if known. List medical conditions under each person's name. Continue the tree downward for children, grandchildren and so on. Older relatives may have more information about those from their generation. Once assembled, the information should be updated annually.

The Department of Health and Human Services has a free software tool for Windows operating systems that can help develop and maintain the family tree and print copies. It is available at http://www.hhs.gov/familyhistory/download.html

With a detailed family medical history, doctors can be very specific in recommending preventive screening and therapy. Naturally, it is important to follow the preventive advice physicians give. Although genetic background cannot be changed, risk factors can be modified.

The human genome has been analyzed, but it will be a while before the complete information can be applied to individuals. Until then, a detailed family history record is the next best thing to a personal genetic profile.

(Media Contacts)

Last Updated March 19, 2009