When it Comes to Cancer Prevention, Family History Matters


Knowing who in your family has had what medical problems at what age, especially if any of those problems were cancer, is very important in mitigating your own cancer risk.  Doctors use family medical history to determine if their patients are at a higher risk for certain types of cancer.  When there is a family history that indicates a higher risk, additional testing or preventative measures may be recommended to help ensure that if cancer develops it is caught and treated early.  For most types of cancer, early detection is one of the keys to long term survival.

When it Comes to Cancer Prevention, Family History Matters“When you see your internist for a checkup, you may answer questions about more than your own health. He or she may ask about the health problems that people in your immediate family and other relatives have experienced and at what ages.

Your doctor uses this information to put together a family health history, which helps pinpoint your risk for a variety of conditions, including breast cancer.

“Having a detailed family history is important because that’s where doctors first get an idea of whether patients have a normal risk or an increased risk of developing a cancer,” says Anthony F. Provenzano, MD, Cancer Committee Chairman at New York-Presbyterian/Lawrence Hospital.

If a family health history suggests a woman might be at higher risk, she can then have genetic testing. These tests tell her whether the increased risk is due in part to an alteration or mutation in her genes. If she’s at higher risk, she may be screened earlier, more frequently, or with different kinds of tools—such as MRI. In some cases, she may be a candidate for primary prevention with a medication such as tamoxifen that can reduce her risk for developing breast cancer.

Typical family health histories, says Dr. Provenzano, can sometimes lack detail which might help physicians interpret a particular cancer risk. As it relates to breast cancer, in addition to BRCA1 and BRCA2 — one of the first hereditary mutations linked to the disease — a number of others have more recently been found. Having a more detailed family health history can help family physicians and oncologists be more confident in interpreting cancer risk as research continues to uncover more information about the causes of cancer.

Many of us simply don’t know much about our family’s health history. “People may know that a first or second degree relative had cancer, but not know what type or at what age they were diagnosed,” says Dr. Provenzano, noting that both are important in assessing risk.

What can you do? If you haven’t done a family health history with your internist, bring it up with your physician. If possible, collect information before your visit to the doctor’s office. Find out about grandparents, aunts, uncles and cousins, as well as people in your immediate family. “You can collect this information over time,” says Dr. Provenzano.

For each relative who has had cancer, record the type of primary cancer, the person’s age at diagnosis, and whether the relative was on your mother’s or father’s side of the family. Ethnicity is also important. For example, those of Ashkenazi Jewish ancestry are more likely to have a BRCA mutation. (If you’d like more information on how to put together a family health history, Dr. Provenzano recommends visiting cancer.net.)

Finally, be aware that if you are found to be at a higher risk for hereditary cancer based on family health history alone, but tested negative for a mutation, you may still need repeated genetic testing as newer mutations are discovered, says Dr. Provenzano.”

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