knowing your family health history could save your life

Why is my family health history so important?

Genes play a part in almost all diseases.

By asking about your family health history, you can find out what diseases may run in your family.

If your family members have a common complex disease like heart disease, diabetes, or cancer, you may have a higher chance of getting that disease yourself.

1. Why should I collect my family's health history?

Your family health history may point to diseases that run in your family.

Once you know which diseases run in your family, you can talk to your doctor about ways to reduce your risk.

You can also talk to other family members about their risk.

2. What exactly is a family health history?

A family health history is a record of your family members and any diseases they have had. It should include details about each disease, how old a family member was when they got a disease, their health habits, and possible hazardous exposures.

3. Who should I include in my family health history?

Your family health history should include blood relatives, such as:

1st Degree Relatives:

Your Parents
Your Children
Your Brothers and Sisters

2nd Degree Relatives:

Your Grandparents
Your Grandchildren
Your Half Brothers and Sisters
Your Aunts and Uncles
Your Nieces and Nephews

3rd Degree Relatives:

Your 1st Cousins

4. What information should I include in my family health history?

Current Ages - Of all family members listed above.
Gender – Of all family members listed above.
Age at Death – If no longer living.
Cause of Death – If no longer living.
Health Status – Healthy or a history of health problems.
Type of Disease – List any known diseases in each family member listed above.
Age When Disease Was Diagnosed
Ethnic Background – Countries your family came from / ancestry.
Health Habits & Environmental Exposures - Health habits and things a family member may have been exposed to can include:

Hormone replacement therapy
Smoking, drinking alcohol, or drug use
Living or working near a chemical or other type of plant
Diet, exercise, and weight control
For women, age at the time of her first period, age when she had her first child, or age at menopause.

You should try to get this information for all of your family members listed above. You may also want to collect medical records on family members who have passed away. Knowing the exact diagnosis allows your doctor to predict your risk for a certain disease. For example, there is a difference between ovarian cancer, uterine cancer, and cervical cancer, and it is important to know which of these a woman had.

5. Now that I have this information, who needs to know about it?

Your Doctor - Your doctor will use this information to decide if you are more likely to get a disease that runs in your family. This information may help your doctor decide if you need to be screened for certain diseases more often or at an earlier age.
Your family members - You and your family members may be at risk for the same diseases. Your family members may want take this information to their doctor to see if screening is right for them

6. How will my doctor know if I have a higher chance of getting a disease?

Your chance of getting a disease is based on:

The number of family members with the same or similar disease
How closely related you are to affected family members
Your family members’ health, habits, and exposures
Your personal health history

Your doctor will look for patterns in your family health history, such as those mentioned above, that suggest you have a higher chance to get a certain disease

7. What do I do once I find out my chance of getting a disease?

Talk to your doctor
If you do not have a family history of common complex diseases, your doctor may talk to you about routine guidelines to screen for these diseases
If a disease runs in your family, your doctor will decide if you need to have screening tests (such as mammogram's or colonoscopies) more often, or starting at an earlier age. Your doctor may also talk to you about other ways to manage your risk
If your family history is strong enough, your doctor may refer you to a geneticist or a genetic counselor. Genetic specialists will talk to you about your family history and discuss whether genetic testing is right for you.

Please see the table below to help determine your risk:

Follow Routine Guidelines If You Have One of the Following:	No affected relatives Only one affected 2nd degree relative on one or both sides of the family No known family history Adopted individual with no known family history
Discuss Risk Management Strategies If You Have One of the Following:	One 1st degree relative with late or unknown age of disease onset Two 2nd degree relatives from the same side of the family with late or unknown disease onset
Consider Specialty Referral If You Have One of the Following:	Early onset of the disease in at least one 1st degree relative Two or more affected 1st degree relatives with disease onset at any age One 1st degree relative with late or unknown age of disease onset and one or more 2nd degree relatives with early onset Two or more 2nd degree relatives from either side of the family with at least one individual with early disease onset Three or more affected relatives from one side of the family with onset at any age

Adopted from Scheuner et al. Am J Med Genet 1997;71:315-324

8. What is genetic testing?

Genetic testing uses blood or other samples from the body to determine if a person has a certain disease or is likely to get it

There are four different types of genetic tests:

Diagnostic - Diagnostic tests tell you if you have a certain disease.
Predisposition - Predisposition tests tell you if it is likely you will get a certain disease in the future. These tests cannot tell you that you will definitely get a certain disease. The test for breast cancer is a predisposition test.
Presymptomatic - Presymptomatic tests tell you if you will get a disease in the future (ex. Huntington Disease).
Carrier - Carrier tests tell you if you have a higher chance of having children with a disease. Most carriers do not have symptoms of the disease. When both parents are carriers for the same disease, there is a one in four chance that each of their children will have the disease. Carrier testing is commonly done for diseases like cystic fibrosis and sickle cell anemia.

9. Is genetic testing right for me?

Genetic testing is NOT RIGHT FOR EVERYONE.
Only a small number of people have a change in their genetic information that increases their chance of getting a disease.
Family health history is used to find out who is more likely to get a disease and who may benefit from getting a genetic test.

10. Is there a good tool on the internet that I can use to help me collect my family history?

The United States Department of Health and Human Services Surgeon General’s website allows you to fill out your family health portrait in English or Spanish at : www.hhs.gov/familyhistory/
The Center for Disease Control National Office of Public Health Genomics website has information and links to several different family history tools at www.cdc.gov/genomics/public/famhix/links.htm