Why it is important to know the family history?

Family history involves the collection of information about the health status of parents and brothers or sisters (german in formal terms, or carnal because they share the same parents and therefore the "Germen").

It is indicated whether they are alive and their state of health (“in apparent good health” if they are alive and healthy; we have already discussed the acronym abs) or, vice versa, whether they are affected by pathologies, or even if they are deceased, for what cause and at what age.

I repeat that for very elderly subjects it is not the case to insist on urging them to remember, but one should not think that this investigation is a mere statistical exercise.

The real purpose of this information is to try to identify whether there are diseases with hereditary characteristics or predisposing factors for certain pathologies in the Patient's Family.

The first case concerns, for example, some forms of diabetes or some forms of colorectal polyposis; while the second case concerns, for example, arterial hypertension, atherosclerosis or ischemic heart or brain disease.

We know that there is still debate today about the actual genetic transmission of some neoplastic forms; certainly it would be good to investigate the existence in the family of breast cancer for women and prostate cancer for men, as well as in general of neoplasms of the colon, rectum or stomach towards which a predisposition could be detected, due to the high number of cases among members of the same family.

When the existence of one of these pathologies is discovered in a family context, it will be possible to write in the medical record: positive family member for etc, etc.

The term “gentilizio” derives from the Latin “gens” which would indicate not so much the Family in itself, but rather the lineage; think for example of the most well-known Roman Gens, the Julian one, which was said to descend from Iulus or Ascanius, son of Aeneas (both Julius Caesar and Octavian were part of it).

Moreover, History reminds us of many famous families affected by hereditary diseases, such as the lineage of the Queen of the United Kingdom, Victoria, or that of the Romanov Tsars of Russia affected by haemophilia, a disease that causes serious insufficiencies in blood coagulation; or families with predispositions for certain neoplastic pathologies, such as the Bonaparte family that counted more than one gastric cancer among its descendants; or again, although much less famous than those already mentioned, the family of the writer for what concerns myocardial infarctions (6 members in two generations).

The family history therefore has an etiological purpose, so to speak, that is, tending to better document any pathologies, of the type mentioned, that the patient should report in the remote or recent pathological history.

However, the family history also has an important preventive purpose.

Consider for example hereditary familial polyposis; if during the interview for the collection of a family history a Doctor were to record its presence in the family history of a Patient, it is clear that preventive colonoscopy investigations would be started on the Patient himself and on the whole Family to highlight any unrecognized cases to be monitored over time or even treated.

A woman over the age of 40 who has never had a mammogram, but who reveals a family history of breast cancer, must certainly be referred for clinical/instrumental checks to exclude a malignant breast disease coexisting with the disease responsible for the hospitalization.

The same applies, obviously, to metabolic pathologies.