Thomas May PhD, Kimberly A. Strong PhD, Muin J. Khoury MD, PhD & James P. Evans MD, PhD
Genetics in Medicine
In 2004, the US Surgeon General launched the Family History Public Health Initiative to increase awareness and discussions regarding family health history (FHx). FHx reflects the combined influences of shared genetic, behavioral, and environmental factors in families. The collection and use of FHx have already been shown to be useful in risk assessment and preventive intervention for cardiovascular disease, osteoporosis, and cancer surveillance/chemoprevention, to name a few.1,2,3 Yet many segments of the population lack adequate access to the genetic component of FHx that might inform their health management. Here, we focus on adoptees, whose lack of genetic FHx normally reflects separation from biological parents as an inherent feature of adoption. However, our fundamental point is applicable to anyone who lacks access to genetic FHx information, which can occur for many reasons. Lack of genetic FHx is not inconsequential; for example, a recent Swedish study of adoptees emphasizes the importance of genetic factors over environmental factors for several cancers.4 Current genetic testing capabilities are at a stage where it is legitimate to ask, “Could targeted genetic analysis offer any potential benefit for those individuals who have no or limited access to family history, such as many adoptees?” And might the potential benefits and risks of genetic analysis differ between adoptees and those with access to their family history information?