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.

Life and Style
ebookNow available in paperback
ebooks
ebookPart of The Independent’s new eBook series The Great Composers
  • Get to the point
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

    Recruitment Genius: E-commerce Partnerships Manager

    £50000 - £100000 per annum: Recruitment Genius: This is a newly-created partne...

    Recruitment Genius: Senior Project Co-Ordinator - FF&E

    £35000 per annum: Recruitment Genius: A Senior FF&E Project Co-ordinator is re...

    Recruitment Genius: Part Time Carer / Support Worker plus Bank Support

    £10 per hour: Recruitment Genius: A delightful, 11 year old boy who lives in t...

    Recruitment Genius: Office Furniture Installer / Driver

    £20000 - £22000 per annum: Recruitment Genius: An Office Furniture Installer /...

    Day In a Page

    No postcode? No vote

    Floating voters

    How living on a houseboat meant I didn't officially 'exist'
    Louis Theroux's affable Englishman routine begins to wear thin

    By Reason of Insanity

    Louis Theroux's affable Englishman routine begins to wear thin
    Power dressing is back – but no shoulderpads!

    Power dressing is back

    But banish all thoughts of Eighties shoulderpads
    Spanish stone-age cave paintings 'under threat' after being re-opened to the public

    Spanish stone-age cave paintings in Altamira 'under threat'

    Caves were re-opened to the public
    'I was the bookies’ favourite to be first to leave the Cabinet'

    Vince Cable interview

    'I was the bookies’ favourite to be first to leave the Cabinet'
    Election 2015: How many of the Government's coalition agreement promises have been kept?

    Promises, promises

    But how many coalition agreement pledges have been kept?
    The Gaza fisherman who built his own reef - and was shot dead there by an Israeli gunboat

    The death of a Gaza fisherman

    He built his own reef, and was fatally shot there by an Israeli gunboat
    Saudi Arabia's airstrikes in Yemen are fuelling the Gulf's fire

    Saudi airstrikes are fuelling the Gulf's fire

    Arab intervention in Yemen risks entrenching Sunni-Shia divide and handing a victory to Isis, says Patrick Cockburn
    Zayn Malik's departure from One Direction shows the perils of fame in the age of social media

    The only direction Zayn could go

    We wince at the anguish of One Direction's fans, but Malik's departure shows the perils of fame in the age of social media
    Young Magician of the Year 2015: Meet the schoolgirl from Newcastle who has her heart set on being the competition's first female winner

    Spells like teen spirit

    A 16-year-old from Newcastle has set her heart on being the first female to win Young Magician of the Year. Jonathan Owen meets her
    Jonathan Anderson: If fashion is a cycle, this young man knows just how to ride it

    If fashion is a cycle, this young man knows just how to ride it

    British designer Jonathan Anderson is putting his stamp on venerable house Loewe
    Number plates scheme could provide a licence to offend in the land of the free

    Licence to offend in the land of the free

    Cash-strapped states have hit on a way of making money out of drivers that may be in collision with the First Amendment, says Rupert Cornwell
    From farm to fork: Meet the Cornish fishermen, vegetable-growers and butchers causing a stir in London's top restaurants

    From farm to fork in Cornwall

    One man is bringing together Cornwall's most accomplished growers, fishermen and butchers with London's best chefs to put the finest, freshest produce on the plates of some of the country’s best restaurants
    Robert Parker interview: The world's top wine critic on tasting 10,000 bottles a year, absurd drinking notes and New World wannabes

    Robert Parker interview

    The world's top wine critic on tasting 10,000 bottles a year, absurd drinking notes and New World wannabes
    Don't believe the stereotype - or should you?

    Don't believe the stereotype - or should you?

    We exaggerate regional traits and turn them into jokes - and those on the receiving end are in on it too, says DJ Taylor