What you are collecting
A useful history covers three generations. Start with your first-degree relatives, who are your parents, siblings and children, and then add grandparents, aunts and uncles. For each person you want the major conditions, the age at which each was diagnosed, and for those who have died, the cause and the age. Note your family's ancestry as well, because some conditions are more common in particular populations.
The conditions that matter most are the common ones with a hereditary component.
- Record heart disease, stroke, high blood pressure and high cholesterol.
- Record type 2 diabetes.
- Record cancers, especially of the breast, ovary, colon and prostate.
- Record depression, bipolar disorder, addiction and dementia.
- Record blood clots, and any sudden unexplained death at a young age.
How to ask
Families are often vague about illness, and older relatives may use phrases such as "heart trouble" or "female problems." Ask specific, gentle questions, one person at a time, and explain that you are asking for your own health. Holiday gatherings are a practical moment, which is why the Surgeon General has declared Thanksgiving to be National Family History Day. The Surgeon General's office also offers a free online tool, called My Family Health Portrait, that organizes the answers into a chart you can print. If you were adopted, the agency or the state may be able to release non-identifying medical information about your birth family, and the rules vary by state.
What changes because of it
Certain patterns move your screening earlier. A parent or sibling with colon cancer usually means you start colonoscopies at 40, or ten years before the age at which that relative was diagnosed, whichever comes first. Heart disease in a father or brother before 55, or in a mother or sister before 65, counts as a risk factor and may mean earlier cholesterol checks. Several relatives on one side with breast, ovarian or related cancers, or a cancer diagnosed unusually young, is a reason to ask about a referral to a genetic counselor.
Keeping it private
A federal law called GINA bars health insurers and most employers from using genetic information, including family history, against you. It does not cover life insurance, disability insurance or long-term care insurance, which is worth knowing before you take a genetic test.
Tip Update the record every few years and share a copy with your siblings. A history is not a verdict, and most of what it reveals is a reason to screen earlier, not a reason to worry.
