Thursday, April 27, 2017

Heightened Health Risks Due to First and Second-Degree Relative's Illness History

A person's family history can be instrumental in diagnosing and treating a number of illnesses, including cancer, obesity, type 2 diabetes and other diseases. The focus on a person's family history typically involves first-degree relatives, however, there may be some value in looking at second-degree family history, especially for clinical management of metabolic diseases.

When a physician examines a patient, the physician obtains, among other things, the patient’s weight, height, and medical history. The physician also asks questions to learn more about the patient’s parents’ medical history, and the patient's siblings' medical history. This is done to help the physician resolve health issues and possibly mitigate the effects of future health issues. When a doctor asks about the patient's immediate or first-degree relatives' medical history, the physician asks these questions because a patient’s relatives’ history can influence the patient’s health.

For example, if one of a patient's immediate relatives has diabetes, the patient's risk of diabetes is higher than normal. And if the patient's parents are obese, this raises the likelihood that the patient might need to pay special attention to his or her weight. The same holds true for some forms of cancer. There is available evidence that at least five cancers are linked to overweight and obesity. These cancers are "adenocarcinoma of the esophagus; colorectal cancer; breast cancer in postmenopausal women; and uterine and kidney cancers."

Not only are first-degree histories important, second-degree relative histories are also important in the management of certain diseases. For example one study concluded that "second-degree FHD [family history of diabetes] could be used as a public-health screening tool to identify children at risk of adverse metabolic outcomes and of possible future disease."

Providers should of course consider the medical histories of their patient's first degree relatives' medical histories. These medical histories can add to the provider's knowledge of the patient, and enhance the patient's clinical treatment. However, some consideration should probably be given to medical histories of second-degree relatives. Because, for some diseases like metabolic diseases, these histories might also be useful.

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