The Family History
Many tools are now available to help you create drawings of your family health history to share with relatives and your health care providers. To view the Surgeon General's "My Family Health Portrait" tool, click here.
In general, a family history to assess cancer risk typically includes the following:
- Information about health history of relatives on the mother’s and father’s side of the family. Hereditary cancer syndromes can be inherited from either the mother or the father.
- Race, ancestry, and ethnicity information for all grandparents. This information may influence decisions about genetic testing because specific gene alterations may occur with increased frequency in selected populations.
- Information about seemingly unrelated conditions, such as birth defects or other noncancerous conditions of children and adults, that may aid in the diagnosis of a cancer susceptibility syndrome.
- A minimum of 3 generations. This will help identify inheritance patterns, as hereditary cancer is often present in successive generations.
A 3-generation family history includes the following:
- First-degree relatives (e.g., children, brothers and sisters, and parents).
- Second-degree relatives (e.g., grandparents, aunts and uncles, nieces and nephews, and grandchildren).
- Third-degree relatives (e.g., cousins, great aunts, and great uncles) are included if these individuals have had cancer and/or one of their first-degree relatives has been affected with cancer.
For any relative with cancer, the following information is collected:
- Type of each primary cancer (i.e., the location in the body where the cancer was first diagnosed and whether it was unilateral or bilateral).
- Relevant cancer treatment and pathology, if known.
- Age at diagnosis for each primary cancer.
- If the individual is still living, current age; if deceased, age at death and cause of death.
- Environmental/occupational exposure history (e.g., tobacco use, radiation exposure, sun exposure).
- Other significant health problems.
For any relative not affected with cancer, the following information is collected:
- Current age or age at death.
- If deceased, cause of death.
- History of any surgeries that reduce the risk for cancer.
- Whether routinely screened for cancer.
- Any noncancerous features of the syndrome in question.
- Environmental/occupational exposure history.
- Other significant health problems.
During the genetic counseling process, the genetic counselor will talk with you about the process and importance of confirming diagnoses. For example, determining if a female relative died from "stomach" or "ovarian" cancer can significantly affect an individual's risk assessment. Pathology reports, medical records, and death certificates are useful documents to collect if available.