Knowing is Not Enough—Act on Your Family Health History

Has your mother or sister had breast cancer? Does your mother, father, sister, or brother have diabetes? Did your mother, father, brother, or sister have colorectal (colon) cancer before age 50? If you answered “yes,” you are more likely to get the same disease as your parent or sibling and should consider earlier screening. Talk to your doctor about when to start screening and what other steps to take to prevent the disease or find it early. Finding disease early can often mean better health in the long run.

Did you know that Thanksgiving is also National Family History Day? Even if you don’t have a parent or sibling with cancer or diabetes, you might be more likely to get a disease if other people in your family have or had the disease. However, having a family health history of a disease doesn’t mean that you will definitely get it. Knowing your family health history risk can help you—if you act on it. Collecting your family health history is an important first step. Whether you know a lot about your family health history or only a little, take time to talk to your family about their health histories at family gatherings this holiday season. It might not be easy. Your family members might not be used to talking about their diseases or might not want to talk. But starting the conversation is important. Remember, you’re asking not just for your own health, but for the health of everyone in your family.

You Can Change Your Family’s Future Health History

“I met three different women who had been tested [genetic testing for mutations in the BReast CAncer susceptibility (BRCA) genes] early on, in 1996, when the BRCA test first came out. They told me their family history story of mothers, aunts, uncles, and a dad who suffered from breast or ovarian or related cancers, and it was heartbreaking. But then the story changed with them. They were diagnosed with cancer, they got testing, and they shared this information with their family members. So they had stories of children and grandchildren—one woman even had great grandchildren—who were old enough to decide whether or not they wanted to be counseled and some decided to get testing. Many did not carry any of the mutations in the family, and others did. And those who found out that they were a mutation carrier, they had actual things to do. And none of them—none of those family members as we cascade down—have died of cancer.”

– Summer Lee Cox, Oregon Public Health Division

How to Collect Your Family Health History

Talk to your family. Write down the names of your close relatives from both sides of the family: parents, siblings, grandparents, aunts, uncles, nieces, and nephews. Talk to these family members about what conditions they have or had, and at what age the conditions were first diagnosed. You might think you know about all of the conditions in your parents or siblings, but you might find out more information if you ask.
Ask questions. To find out about your risk for chronic diseases , ask your relatives about which of these diseases they have had and when they were diagnosed. Questions can include:
- Do you have any chronic diseases, such as heart disease or diabetes, or health conditions, such as high blood pressure or high cholesterol?
- Have you had any other serious diseases, such as cancer or stroke? What type of cancer?
- How old were you when each of these diseases or health conditions was diagnosed? (If your relative doesn’t remember the exact age, knowing the approximate age is still useful.)
- What is your family’s ancestry? From what countries or regions did your ancestors come to the United States?
- What were the causes and ages of death for relatives who have died?
Record the information and update it whenever you learn new family health history information. My Family Health Portrait , a free web-based tool from the Surgeon General, is helpful in organizing the information in your family health history. My Family Health Portrait allows you to share this information easily with your doctor and other family members.
Share family health history information with your doctor and other family members. If you are concerned about diseases that are common in your family, talk with your doctor at your next visit. Even if you don’t know all of your family health history information, share what you do know. Family health history information, even if incomplete, can help your doctor decide which screening tests you need and when those tests should start.

If you have a medical condition, such as cancer, heart disease, or diabetes, be sure to let your family members know about your diagnosis. If you have had genetic testing done, share your results with your family members. If you are one of the older members of your family, you may know more about diseases and health conditions in your family, especially in relatives who are no longer living. Be sure to share this information with your younger relatives so that you may all benefit from knowing this family health history information.

How to Act on Your Family Health History

Knowing about your family health history of a disease can motivate you to take steps to lower your chances of getting the disease. You can’t change your family health history, but you can change unhealthy behaviors, such as smoking, not exercising or being active, and poor eating habits . Talk with your doctor about steps that you can take, including whether you should consider early screening for the disease. If you have a family health history of disease, you may have the most to gain from lifestyle changes and screening tests.

What you can do if you have a family health history of

Colorectal cancer: If you have a mother, father, sister, brother, or other close family member who had colorectal cancer before age 50 or have multiple close family members with colorectal cancer, talk to your doctor about whether you should have screening starting at a younger age, being done more frequently, and using colonoscopy only instead of other tests. In some cases, your doctor may recommend that you have genetic counseling, and a genetic counselor may recommend genetic testing based on your family health history.
Breast or ovarian cancer: If you have a parent, sibling, or child with breast cancer, talk to your doctor about when you should start mammography screening. If your relative was diagnosed with breast cancer before age 50, if you have a close relative with ovarian cancer, or if you have a male relative with breast cancer, your doctor might refer you for cancer genetic counseling to find out if genetic testing is right for you. In some cases, your doctor might recommend taking tamoxifen or raloxifene, drugs that can decrease risk of developing breast cancer in some women.
Heart disease: If you have a family health history of heart disease, you can take steps to lower your chances of getting heart disease. These steps can include eating a healthy diet, being physically active, maintaining a healthy weight, not smoking, limiting your alcohol use, having any screening tests that your doctor recommends, and, in some cases, taking medication.
Osteoporosis: This is a medical condition where bones become weak and are more likely to break. A family health history of osteoporosis is one of a number of factors that make you more likely to develop osteoporosis. For example, if you are a white woman whose mother or father fractured their hip, talk to your doctor about screening for osteoporosis earlier (at about age 55, compared with age 65 for most women). You can use the FRAX Risk Assessment tool to learn if you should be screened.
Diabetes: If your mother, father, brother, or sister has type 2 diabetes, you could have prediabetes and are more likely to get type 2 diabetes yourself. But there are important steps you can take to prevent type 2 diabetes and reverse prediabetes if you have it. Take this test to find out if you could have prediabetes. Ask your doctor whether you need earlier screening for diabetes. Find out more about the National Diabetes Prevention Program’s lifestyle change program and how to find a program near you. Discover how to make healthy food choices , move more , and set a weight loss goal .