Know Your Family Health History
Family health history is one tool that healthcare providers use to assess an individual's risk of cancer and other diseases. Knowing which health conditions affect which family member, and at what age, can help you understand whether you may be at increased risk and, if necessary, take steps to reduce that risk.
The following online tools and worksheets are designed to help you collect and record key family health information. They also make it easier to share the information with health providers and other members of your family.
Try to gather health information about your parents, grandparents, siblings, children, aunts and uncles on both sides of the family. The more information you can provide the better. If you can’t collect information about all your relatives, just collect as much as you are able. Even a partial family health history can provide insight.
It is impossible to tell from family history alone whether or not you are at risk for hereditary cancer. However, if you find one or more of the following in your family health history, meeting with a genetic counselor for a cancer risk assessment may be appropriate:
- Two or more closely related individuals with breast cancer, diagnosed at any age
- Cancer diagnosed at young ages (before 50)
- Multiple cancer diagnoses in one individual (e.g. breast and ovarian, bilateral breast cancer)
- Individuals affected in multiple generations (e.g. grandfather, mother and aunt)
- Rare cancers such as ovarian cancer or male breast cancer
Two or more family members with the same type of cancer (e.g. breast, ovarian, prostate, uterine, colon or stomach cancers)
- Ashkenazi Jewish ancestry
What is a Cancer Risk Assessment?
A cancer risk assessment is a type of genetic counseling
appointment conducted by a genetic counselor or medical geneticist that
- A thorough evaluation of one’s personal and family history of cancer
- An assessment of the likelihood that a gene mutation is the cause of cancer in the family
- A discussion of the risks and benefits of genetic testing
- An explanation of the options for managing an increased risk of cancer
What are Genetic Counselors?
Genetic counselors provide education and personalized support for individuals and families affected by – or at increased risk for – genetic disorders. They have advanced training in medical genetics and counseling and can: assess risk; help individuals think through the benefits and drawbacks of genetic testing and make informed decisions; interpret test results; and discuss available options and provide resources. Genetic counseling is essential for all people considering BRCA testing.
What are Medical Geneticists?
Medical geneticists provide similar information and resources, but have expertise as physicians and may also help treat genetic disorders. They are able to provide information from a medical standpoint and provide medical care to an individual or family.
What is Genetic Testing?
Genetic testing is used to identify patients who have
genetic mutations that may significantly increase their risk of developing a
disease (e.g., cancer) and may benefit from increased cancer surveillance
and/or other preventive measures, such as prophylactic surgery. Prior to the
test, a genetic counselor or medical geneticist can discuss the benefits and
risks of genetic testing, as well as the implications of positive and negative
results and any factors that may influence your decision about whether you want
to proceed with testing. This testing may pertain to family planning or
personal health, and may test for either recessive carrier disorders or
hereditary types of cancer.
Genetic testing for hereditary cancers is more involved than the average blood test because it invokes issues of:
- Test-related anxiety — what will you do with the information?
- Privacy and confidentiality — who has access to the information?
- Genetic discrimination — what are the myths and realities?
- Psychological effects within families — how will your genetic test results affect your family members and how do they feel about you being tested?
Genetic counseling is recommended both before and after
testing to prepare patients for the test and to help them understand the
results that come back.
What are the Benefits of Knowing you Have a Hereditary Cancer Predisposition Gene?
Genetic testing can help you and your doctor better understand your health
risks so that together you can determine a management plan that is right for
you. This may include more frequent examinations, blood tests, imaging, or risk-reducing
Genetic testing is not right for everyone. For example, some
people may find that knowing about a mutation or cancer predisposition causes
increased anxiety. A genetic counselor can help you think through the
implications of testing and help you make an informed decision. If you decide
not to undergo genetic testing, you may talk to your doctor about whether
increased cancer surveillance is appropriate for you.
If you would like to ask a genetic counselor about risk
assessment and testing, please contact us.