Family Health History

Know Your Risk

Family health history is a record of your family’s health information. It includes information about conditions that run or are common in your family. This history covers details about the person collecting the information (you) and the health of those related to you by birth, like your children, siblings, parents, aunts, uncles, and grandparents.

Understanding family health history helps patients and health care providers identify potential risks based on genetic, environmental, and lifestyle factors that can affect health. It also helps patients and providers create a plan for better health outcomes.

Why it’s Important to Know Your Family Health History

Certain health conditions are passed down from generation to generation within families. Your family health history can help you and your health care providers understand your risk for developing these conditions. If your family history suggests a potential genetic condition, your provider may recommend genetic counseling or testing.

Knowing your family health history can guide your health care. It helps determine what preventive care, testing, and treatment may lower your risk or prevent conditions from developing. For example, if you have a concerning family health history, you might need to start mammograms or colonoscopies earlier than the typical recommended age.

This information may also help your provider identify ways, like recommending statin therapy earlier to manage cholesterol.

Gathering Your Family Health History

To gather your family health history, start by talking to your relatives about their health. Many families have someone who knows a lot about the family's medical history. Family gatherings can be a good time to start these conversations. Here are some tools that may help:

  • Families SHARE Workbooks
    This toolkit funded by the National Human Genome Research Institute helps families understand how their family health history affects their disease risk.
  • My Family Health Portrait
    The CDC's online tool lets you create a digital record of your family health history and share it with your health care provider.
  • Does it Run in the Family
    A toolkit from the Genetic Alliance helps you collect, organize, and understand your family health history.

Cancer-Specific Family Health History Collection Resources

What Should I Include in my Family Health History

A complete family health history typically includes at least 3 generations from both sides of the family:

  • You and your siblings
  • Your parents and their siblings (aunts and uncles)
  • Your grandparents or children. You can include both if known, applicable, or available.

For each family member, try to include:

  • Age or date of birth
    • Age at diagnosis: If possible, note when they were first diagnosed with the condition.
    • If the relative has passed away, include their age and cause of death, if known.
  • Health Conditions: This can be anything they are diagnosed with or anything that you or they consult a doctor regularly for, such as high cholesterol or diabetes.

Family health history can change over time. Check in with your relatives every few years and update your records.

Additional Family Health History Considerations

Here are a few additional considerations to be mindful of when gathering your family’s health history.

  • It’s important to ask everyone. Make sure to collect information from both sides of your family. This is important, regardless of your sex assigned at birth or which side of the family you resemble more.
    • Example: If you are a woman, you still need to get the health history of your father's side of the family.
    • Example: If you are a man, ask about breast cancer in the family. Men can inherit genes that increase the risk of breast cancer, too.
  • Be mindful of the organs your relatives had at birth because some health risks are linked to specific organs, like the ovaries or the prostate.
    • Example: If you have a strong family history of ovarian cancer, especially from a parent, you or your siblings born with ovaries may have a risk. It's important to remember that even if someone identifies as a male, if they were born with ovaries, they might still be at risk for ovarian cancer. If you have had an organ removed, like a total hysterectomy (uterus removal that includes the removal of the ovaries), your risk of related cancers may be much lower or even nonexistent.
  • Definitions of family and certain relatives differ between cultures. But when it comes to family health history, it’s important to clarify biological relationships, including:
    • Half-siblings
    • Adopted family members
  • Sharing health information can feel uncomfortable.
    • Offer to speak privately with them or ask them to write it down.
    • Explain why understanding your family health history can help you and other relatives make informed health decisions and live longer, healthier lives.

Age at Diagnosis Matters

Age at diagnosis can give important clues to understanding certain conditions. Your family’s health history information helps health care providers identify if your family has a pattern of early-onset conditions, which could mean you're at a higher risk.

For example:

  • As we age, our body's ability to maintain health declines, so it's not unusual for an 80-year-old to have heart disease. However, heart disease in a 30-year-old is much less common and might suggest underlying genetic risk factors.
  • Age can help healthcare providers determine when to start screenings. If your mom had breast cancer at 40, you may need to start breast cancer screening at 30. Talk to your provider to determine the appropriate screening age for you.

Age at Death Matters

Knowing the age at which a relative passed away helps health care providers understand whether they passed away earlier than expected due to their health condition.

If multiple relatives passed away at a younger age than typical, it might indicate a hereditary health issue or other shared risk factors. Hereditary means a condition passed down from parents to their child or health concerns that run in families.

Health Issues That May Indicate Increased Risk

When discussing your family health history, some “red flags” or clues that may suggest a higher likelihood of a genetic factor to the health conditions in your family. Talk to your provider if you notice these red flags:

  • Several family members with the same or related diagnoses. For example, 3 relatives with colorectal or colon cancer.
  • Symptoms starting at an earlier age or disease diagnosed sooner than typically expected. For example, a breast cancer diagnosis before age 50.
  • Conditions affecting both sides of the body or multiple sites in the same organ like cysts in both kidneys.
  • Unusual presentation of a common condition, like high cholesterol in a child.
  • A disease in someone of the less commonly affected sex. For example, a man diagnosed with breast cancer.
  • Presence of disease in otherwise healthy people like arrhythmia or irregular heartbeat in a healthy 25-year-old.
  • Any family history of:
    • Developmental delay or intellectual disability
    • Disorders at birth, like cleft lip or heart defect
    • Stillbirth or childhood death
    • Infertility or more than 3 unexplained miscarriages
  • Certain populations have a higher chance of genetic conditions like Sickle Cell disease among people of African descent or Tay-Sachs disease in people of Ashkenazi Jewish descent. Belonging to these populations does not mean you have the condition, but it could mean you have a higher chance of having the condition.

Genes aren’t always the whole story.

Families share more than genes and not all family health risks are tied to genetics. Most families also share other things that contribute to health history and risk factors such as:

  • Where they live
  • What they eat
  • How they deal with stress
  • Their lifestyle and habits like smoking or being active

Your provider can help assess your overall risk and recommend steps for prevention and reduction. Keeping your family health history up to date in your medical record is one way to find out which genetic factors affect your health.

What It Means to Have Health Conditions Common in Your Family

Having a condition common in multiple family members increases your risk of developing that condition. However, a higher risk doesn't mean you will definitely develop it.

Similarly, not having a family history doesn't mean you're entirely safe from it.

Conditions like heart disease, diabetes, kidney disease, and various cancers, are influenced by family health history. Family health history helps identify patterns that might suggest an inherited risk.

Genetics play a big role in increasing a person’s risk for some inherited conditions. This happens when someone is born with a specific genetic difference, sometimes called a mutation. These differences act like a “spelling error” in their body’s instruction manual. These mutations can increase their lifetime risk of developing certain conditions a lot.

  • For example, people with a difference in one of their BRCA1 (associated with hereditary breast and ovarian cancer syndrome) genes have a 72% lifetime risk of breast cancer. The general population risk is about 13%.

But even then, genes don’t always determine your future health risk. For example, heart disease can run in families, but lifestyle choices like diet, exercise, and smoking habits can still make a difference.

Most diseases are caused by a mix of genetics, lifestyle, and environment. Understanding your family health history allows you and your health care provider to take proactive steps to help lower your risk.

Here is more information on how family health history impacts your risk for some of the most common conditions in the population.

What To Do After You Collect Your Family Health History

The best way to use your family health history is to share it with your health care team. They can use it to assess your risk and develop a tailored plan to help you stay healthy. Based on what conditions are in your family, your provider may:

  • Offer reassurance: If there aren’t any major risk identified, your provider may reassure you that no additional steps are needed. But it is important to keep your family health history updated and record any significant changes.
  • Refer you to a specialist: This could include a genetic counselor or another specialist for further evaluation like genetic testing.
  • Change preventative screening schedules: They might recommend starting screenings like mammograms or colonoscopies earlier or doing them more often.
  • Adjust medications or treatments: They may suggest starting or adjusting medications to lower your risk.

Don’t Know Your Family Health History? That’s OK

We understand that not everyone knows or has access to their family health history.

There are still some steps you can take to understand, manage, and identify potential health risks:

  • Start by discussing your own health and medical history, lifestyle, and habits with your health care provider.
  • Consider genetic testing which can provide insights into genetic risk without family health information. There are many genetic testing options out there. It may be best to talk with a genetic counselor first. Learn more about direct to consumer (DTC) genetic testing kits.
  • Keep up with preventative care to help find health issues early:

Important note: Many health guidelines and screenings are based on age and general risk factors, not just family health history. Talk to your health care provider about health screening guidelines for certain conditions, and tell them if you have any concerns about your risks.

Risk calculators you can use

There are validated cancer and cardiovascular disease-specific risk assessment tools you can use for certain conditions. Make sure to share the results of these tools with your health care provider to create a plan for you.

  • PREVENT Online Calculator
    A calculator from the American Heart Association to predict risk of heart disease EVENTs. This tool should not be used if you have heart disease or failure.
  • Breast Cancer Risk Assessment Calculator
    The National Cancer Institute’s lifetime breast cancer risk assessment calculation.
  • PREMM 5 Model
    This calculation estimates the likelihood of a person having a mutation in a gene associated with Lynch Syndrome (a hereditary colon cancer condition).

If you were adopted or born using sperm egg donation, adoption or donation agencies may be able to provide health records.

Preventive care is important regardless of your or your family's health conditions—and whether you know your family's health history. While you can’t change your genes, you can still practice healthy habits such as being active, eating a balanced diet, and staying smoke-free.

Helpful Resources