How a family tree can save your life

Finding out which conditions afflicted our forebears can tell us more about the risks we face than expensive genetic tests. Hugh Wilson reports

The word Alzheimer's is not one you skip over lightly, especially when it appears in a document describing the illnesses and infirmities that have afflicted your own family. But Alzheimer's makes an appearance twice in a family history that, so far, covers a total of 15 people. I knew that my aunt had died of the disease in her 80s. But my grandfather on my dad's side died before I was born, and I had been blissfully unaware that he had also succumbed to Alzheimer's – and at a frighteningly young age.

But there is good news, too. A little research and a long chat with my mum (who knows about these things like a good matriarch should), have produced a basic family health history, covering my children, sibling, parents, grandparents, aunts and uncles on both sides and some of my cousins. There is only one mention of cancer and no heart attacks. If there is heart disease and high cholesterol in the immediate family, it has never been severe enough to creep into the collective memory, and certainly nobody has died of it.

So far, so OK. I'm digging about in recent family history for the good of my health, of course, and for the good of my children's health. Family health histories have recently been called "the best kept secret in healthcare", after new research discovered that a good one can trump costly genetic testing in predicting what illnesses you and your children may face.

In the study, carried out by researchers at Cleveland Clinic's Genomic Medicine Institute in Ohio, 44 people were asked to produce accurate family health histories and have a saliva swab sent for genetic testing, to calculate their risk for colon cancer and breast or prostate cancer.

Both methods suggested about 40 per cent of participants had a higher than average risk. But they didn't pick the same people. In the colon cancer test, for example, the swab missed all nine people with a family history of the disease, five of whom were later found to have a specific gene mutation linked to the cancer.

"A good family health history is, and always has been, very accurate for predicting risk of disease," says the clinic's Dr Charis Eng. "Remember the old actuaries? They always said that, and they – and your grandma – were right."

But if the latest research only confirms what we've all known for decades, it does beg the question of why family health histories are not already a standard tool in the GP's armoury? "Family health histories are the cheapest, best way to ascertain disease risk [for certain diseases]," says Dr Eng. "Doctors seem to have lost the fine art of taking accurate family histories. On both sides of the Atlantic, is it possible that doctors feel too rushed because they are called upon to do more with less time?"

GPs would undoubtedly agree that coaxing good family health histories from every patient is one job they could do without. But there's no reason why we can't tap into this powerful health tool ourselves, and experts are encouraging us to start health histories of our own.

Online tools have been created to help ( this, from the American Government, is particularly thorough). Creating a family health history online makes it easy to email a copy to your relatives, update it when any new information arrives and print it out to show your GP.

Nor do you have to approach your health history with the fervour of an amateur genealogist with an interesting bloodline. Dr Eng says that, while genetic professionals will often reach back into five generations of a family, for screening purposes first and second-degree relatives are fine. First-degree relatives are children, siblings and parents, with second-degree relatives including uncles, aunts and grandparents. First cousins may be a useful inclusion, too.

But remember, you need to include both sides of the family. Research presented last month showed that women were, mistakenly, more dismissive of the threat of breast cancer if it showed up only in the paternal line.

Once you've created a family health history, you can study it for patterns of illness and show it to your GP if you have concerns. But GP Dr Sarah Brewer, author of the Natural Health Guru series (Wiley), cautions that even strong patterns shouldn't be viewed fatalistically. "Family history can be an important indicator of predisposition to certain diseases – some cancers, heart disease, diabetes, Huntington's chorea and so on. But lifestyle is also important, as the majority of diseases are multifactoral. It's important to remember that diet and lifestyle can often beat genes at their own game."

In other words, a health history can be a call to action. If there turns out to be a history of colon cancer in the family, your diet and lifestyle can work to counter the small increased risk. You can pass that advice on to your children, too.

My own family health history shows a smattering of allergies, as well as asthma, emphysema and bronchitis – though the last two may be smoking-related. Happily, I haven't (to my knowledge) inherited any of them. The osteoporosis on my mother's side of the family is more of a worry to me than to my baby daughter, who will at least be in a position to make early lifestyle choices to mitigate the effects. For the moment, she can take comfort in the fact that six decades of medical advances might render those efforts redundant.

My dad died of bladder cancer, but Dr Brewer says that any hereditary connection is not strong. "Most of the mutations that develop in bladder cells do so during a person's lifetime rather than being inherited." On the downside, she agrees that "Alzheimer's is your strongest potentially hereditary condition, although familial Alzheimer's accounts for fewer than 10 per cent of patients". Should I be worried? At first glance the answer seems to be "very", but more analysis of my family health history provides a bit more comfort. Familial Alzheimer's disease is rare but undoubtedly inherited, and develops before the age of 65.

That happened with my grandfather, but my dad never showed any hint of mental decline and his twin brother lived well into his 70s without developing the disease. "In that case there is a very good chance, assuming your grandad did have an inherited form of Alzheimer's, that your father didn't inherit the causative gene," says Dr Brewer.

Which is good news indeed, though I may be following developments in the field of Alzheimer's research more closely from now on.

In the meantime, I'll spend next Christmas pressing cousins about half-forgotten hospital stays and cholesterol counts. It will be my present to the family.

Making a family health history

* Don't forget to start with your own health, then include parents, children and siblings, followed by grandparents, aunts, uncles and, ideally, cousins.



* Grill (gently) both sides of the family. And remember female illnesses can pass down male lines.



* Be as thorough as possible, but remember that some family members may be reluctant to get into too much detail.



* Ask about the age when problems started, and the cause and age of any deaths.



* If possible, include lifestyle information. Do relatives smoke or drink? Do they take regular exercise?



* Update the history when new information becomes available, and pass it on to relatives who want a copy.

Arts and Entertainment
Supporting role: at the Supreme Court, Rhodes was accompanied by a famous friend, the actor Benedict Cumberbatch
booksPianist James Rhodes on the extraordinary legal battle to stop the injunction of his memoirs
Sport
Sam Allardyce
sport
Sport
Steven Gerrard scores for Liverpool
sport
Arts and Entertainment
Bob Dylan
art
Life and Style
ebookNow available in paperback
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Guru Careers: Software Developer / C# Developer

    £40-50K: Guru Careers: We are seeking an experienced Software / C# Developer w...

    Guru Careers: Software Developer

    £35 - 40k + Benefits: Guru Careers: We are seeking a Software Developer (JavaS...

    SThree: Trainee Recruitment Consultant / Resourcer

    £18000 - £23000 per annum + Commission: SThree: As a Trainee Recruitment Consu...

    Ashdown Group: UI Developer - (UI, HTML, CSS, JavaScript, AngularJS)

    £25000 - £40000 per annum: Ashdown Group: UI Developer - (UI, JavaScript, HTML...

    Day In a Page

    Sun, sex and an anthropological study: One British academic's summer of hell in Magaluf

    Sun, sex and an anthropological study

    One academic’s summer of hell in Magaluf
    From Shakespeare to Rising Damp... to Vicious

    Frances de la Tour's 50-year triumph

    'Rising Damp' brought De la Tour such recognition that she could be forgiven if she'd never been able to move on. But at 70, she continues to flourish - and to beguile
    'That Whitsun, I was late getting away...'

    Ian McMillan on the Whitsun Weddings

    This weekend is Whitsun, and while the festival may no longer resonate, Larkin's best-loved poem, lives on - along with the train journey at the heart of it
    Kathryn Williams explores the works and influences of Sylvia Plath in a new light

    Songs from the bell jar

    Kathryn Williams explores the works and influences of Sylvia Plath
    How one man's day in high heels showed him that Cannes must change its 'no flats' policy

    One man's day in high heels

    ...showed him that Cannes must change its 'flats' policy
    Is a quiet crusade to reform executive pay bearing fruit?

    Is a quiet crusade to reform executive pay bearing fruit?

    Dominic Rossi of Fidelity says his pressure on business to control rewards is working. But why aren’t other fund managers helping?
    The King David Hotel gives precious work to Palestinians - unless peace talks are on

    King David Hotel: Palestinians not included

    The King David is special to Jerusalem. Nick Kochan checked in and discovered it has some special arrangements, too
    More people moving from Australia to New Zealand than in the other direction for first time in 24 years

    End of the Aussie brain drain

    More people moving from Australia to New Zealand than in the other direction for first time in 24 years
    Meditation is touted as a cure for mental instability but can it actually be bad for you?

    Can meditation be bad for you?

    Researching a mass murder, Dr Miguel Farias discovered that, far from bringing inner peace, meditation can leave devotees in pieces
    Eurovision 2015: Australians will be cheering on their first-ever entrant this Saturday

    Australia's first-ever Eurovision entrant

    Australia, a nation of kitsch-worshippers, has always loved the Eurovision Song Contest. Maggie Alderson says it'll fit in fine
    Letterman's final Late Show: Laughter, but no tears, as David takes his bow after 33 years

    Laughter, but no tears, as Letterman takes his bow after 33 years

    Veteran talkshow host steps down to plaudits from four presidents
    Ivor Novello Awards 2015: Hozier wins with anti-Catholic song 'Take Me To Church' as John Whittingdale leads praise for Black Sabbath

    Hozier's 'blasphemous' song takes Novello award

    Singer joins Ed Sheeran and Clean Bandit in celebration of the best in British and Irish music
    Tequila gold rush: The spirit has gone from a cheap shot to a multi-billion pound product

    Join the tequila gold rush

    The spirit has gone from a cheap shot to a multi-billion pound product
    12 best statement wallpapers

    12 best statement wallpapers

    Make an impact and transform a room with a conversation-starting pattern
    Paul Scholes column: Does David De Gea really want to leave Manchester United to fight it out for the No 1 spot at Real Madrid?

    Paul Scholes column

    Does David De Gea really want to leave Manchester United to fight it out for the No 1 spot at Real Madrid?