Hand-Me-Down Genes

Whenever doctors asked Dan Maier, 29, if cancer ran in his family, he always said no. That was before he brought a tape recorder to brunch with his 92-year-old grandmother and asked her to help him construct a family history. In the process, Maier learned that his grandfather, who died in a car accident, also suffered from leukemia. He later discovered that his mother's father had skin cancer-and he plans to be more careful in the sun from now on. In fact, Maier, a spokesman for the American Medical Association, was so struck by what he learned that he included an innovative idea in the AMA's 1992 list of "New Year's Resolutions for a Healthier America": write a family health history.

Physicians have long been asking patients about their medical backgrounds. But many say they are amazed at how few people know what their grandparents--even their parents--died of and at what age. As scientists uncover hereditary links for more and more diseases , it is increasingly vital to learn what ailments lurk in family trees. Some hereditary traits like schizophrenia can't be prevented, but early warning of others such as heart or certain cancers can dramatically improve your own health and longevity (box). "Preventive care is almost like a board game--Clue," says Dr. Michael Fleming, a family practitioner in Shreveport, La. "You're going into the past to find out things about a patient that may help you prevent problems in the future."

Just as in researching a general family history, talk with older relatives may be the best source of information, experts say. Genealogical records don't always include causes of death. Medical terms have also changed over the years. "What people used to call 'consumption' was tuberculosis," says Fleming. "Dropsy was congestive heart failure." Even learning what general symptoms an ancestor had can yield valuable insights. Old photos of a stooped-back great-grandmother could be a clear indication of osteoporosis, for example. "If you hear that a grandparent lost a lot of weight and died fairly suddenly years ago, they probably had cancer," says Dr. Thomas R. Reardon, a family practitioner in Portland, Ore.

Some conditions were covered up in past generations. Yet discovering a family history of birth defects like cystic fibrosis or Tay-Sachs can be critical to couples trying to conceive; tests can determine if they are carriers of such , or if amniocentesis is warranted. "Ask, a grandparent-were there other children who didn't survive and why?" says Maier. "You might learn about relatives you didn't know you had."

Even if information about your ancestors is limited, assembling an ongoing health record for current family members can be a valuable legacy. And, says Reardon, "The time to h your family history and do something about it is in your 20s or 30s-not in your 50s after you've had a heart attack." In other words, those who never learn about their family health history may be condemned to repeat it.

If these conditions run in your family, you could benefit from early detection and treatment:

Annual tests for blood in the stool beginning at age 30 rather than 40.

Annual mammograms beginning at age 35; frequent self-exams.

Annual pap smears beginning at age 20; women with genital warts are especially at risk.

Blood-sugar tests; avoid obesity.

Cholesterol screenings every one to five years; careful diet and exercise.

Testing at age 40, not 50-especially for those with diabetes or hypertension.

Bone-density assessment before menopause; possibly calcium or estrogen.

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