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| :: Recording Family Histories Can Save Lives :: |
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Despite that fact that knowing your family?s medical history can save your life, most Americans remain in the dark. According to the Centers for Disease Control and Prevention in Atlanta, Ga., only three in ten people record the health histories of their relatives. For women, the task of recording a family health history can be even more challenging.
Until the last 10 to 15 years, there was little recognition by doctors or patients of sex and gender differences in health. Diseases traditionally classified as ?male diseases,? such as heart disease, were often left unrecorded and ignored in women?s family histories. We now know that heart disease is the number one killer of American women, and heart attack symptoms differ between the sexes. Only recently has the medical community recognized these important distinctions. So even if you can locate your family?s medical history, the information may be incomplete.
Cancer is another disease that needs to be traced. Breast cancer, ovarian cancer, melanoma, colorectal cancer, and endometrial cancers are among many diseases that can run in families. Genetic testing is a tool that can be used to better assess an individual?s risk for certain diseases. The testing analyzes a person?s genetic makeup for signs in their DNA of increased disease risk. Genetic counseling with health care professionals is also available to help patients make medical decisions based on information gained through genetic testing.
The answers from genetic testing are not always clear cut. Take breast cancer, for example. The chance of a woman having breast cancer during her lifespan is roughly one in eight, according to the American Cancer Society. Some women have a higher risk, especially those with a family history of the disease. Certain gene mutations, known as BRCA-1 and 2, have been discovered and predispose women to develop breast cancer. But the value of screening for the genetic mutations differs depending on who you ask.
Some cases are more obvious than others. ?If a woman has a history of early-onset breast cancer running through first-degree relatives of her family,? the value of genetic screening is usually clear, says Luba Djurdjinovic, M.S., head of the Genetic Counseling Program in Binghamton, N.Y. First degree relatives include parents, siblings and children.
Other cases are more challenging. Family histories may not point to BRCA-1 or 2 gene mutations, but to lesser known genetic mutations that can be equally dangerous to health.
?Mutations in the gene P-TEN can increase a woman?s risk of breast cancer, as well,? Djurdjinovic said. Women need to pay attention to patterns of thyroid disease in their family, which may be an indicator of increased breast cancer risk because it may also be tied to this mutation.
According to Myrna Ben-Yishay, M.S., a genetic counselor at Montefiore Medical Center in New York, genetic counseling is recommended for women ?with a personal or family history of breast cancer before age 50 or ovarian cancer at any age? or ?two or more primary diagnoses of breast or ovarian cancer? in the family.
Ben-Yishay says an occurrence of male breast cancer in the family or breast or ovarian cancer at any age in families of Ashkenazi Jewish descent merit genetic counseling.
Genetic testing may be appropriate for some patients and less appropriate for others. ?The decision to have genetic testing should be made in the context of the entire family history and risk assessment,? says Ben-Yishay.
There are benefits and limitations with genetic counseling. When genetic testing confirms an individual?s heightened risk for a disease, they can receive more frequent health screenings or preventive treatment. These steps can improve survival rates through early detection of disease or decrease the chance of developing the disease.
On the other hand, genetic information can have negative emotional effects on the individual or family. Genetic testing often provides an ambiguous or unclear result, and even if a woman tests negative for a gene mutation, it doesn?t mean that she is off the hook. She still needs to be vigilant and follow the recommended guidelines for health screenings and physical examinations.
As we learn more and more about genetics and disease, screening tools will become more sophisticated and accurate. Whatever role genetic testing plays in the future, it will always be important to track patterns of disease in your family to safeguard your health and the health of future generations.
? March 16, 2006 Society for Women's Health Research
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