With the holidays upon us, here’s a new topic for your family gatherings: your family’s health history. When multiple generations get together, Sylvia S. Estrada, DNP, who provides genetic counseling and testing at the Saul and Joyce Brandman Breast Center at Cedars-Sinai, says you have a perfect opportunity to gather information that will help your healthcare provider better screen against diseases that can run in the family.
From which family members or which generations of the family should parents start collecting information?
There’s always that family historian person who knows everything about the family history, so that would be a great person to tap into. Start with the individual who is interested in capturing the family health history, then record that person’s siblings and parents, and their children. Then branch out. Go as far back as you possibly can. If you can get at least one or two generations, that would be a great place to start.
Which diseases and conditions are most important to find out about?
The most common diseases that we know have an important hereditary predisposition are Alzheimer’s, asthma, cancer, heart disease, diabetes and hypertension. Those are the main disease entities that we as healthcare providers always ask about.
I work in the cancer world, so I’m a little bit biased. It is important to determine what cancers run in the family – breast, ovarian, colorectal, prostate, pancreatic, melanoma. When documenting family members who have had these cancers, it’s important to ask how old they were when they had their diagnosis. Did their cancer recur? If the family member died, did they die of their cancer or did they die of, say, heart disease?
Is there other information that people should be collecting about their family’s health history?
Sure! Lifestyle and health habits, diet and nutrition and occupation. Talk about exercise. Did a lot of family members lead a sedentary lifestyle? Were they smokers or drinkers? Were they exposed to pesticides or chemicals at work?
Obesity is another important thing to discuss. If my grandparents were overweight, my parents were overweight, I’m overweight and now my children are overweight, I should recognize that obesity is a familial health problem.
What’s the best way for families to get this project started?
At family events, start that conversation. Designate one individual to be the family historian and update the family health information as needed. There are great resources out there to help individuals start to document their family history. One is “My Family Health Portrait” (www.familyhistory.hhs.gov). It’s actually endorsed by the National Cancer Institute, and it’s an electronic version of how to create a family history and how you can save it.
If families are concerned about putting this information online, are there other ways that you recommend that families keep all this and still make it available when it is needed?
Sure. There is a healthcare provider card that individuals can fill out available online at GeneticAlliance.org, an organization to facilitate the gathering of family health information. There are also booklets there to educate individuals on how to take a family history and the importance of genetics and health. All of that is available free of charge.
How often should families update their family health history?
Once a year is a good practice. Anything can happen in 12 months.