FAMILY HISTORY - A COMPREHENSIVE GENETIC RISK ASSESSMENT METHOD FOR THE CHRONIC CONDITIONS OF ADULTHOOD

Targeting individuals with increased risk for common, chronic disease can improve the efficiency and efficacy of preventive efforts by impro ving the predictability of screening tests and participant compliance, Individuals with the greatest risk for these disorders are those with a genetic susceptibility, The purpose of this study was to determine the feasibility of using a single, comprehensive family history as a m ethod for stratifying risk for many preventable, common genetic disord ers, Family histories obtained in a prenatal diagnostic clinic were re viewed regarding cardiovascular diseases, diabetes and several cancers ; 42.5% of individuals reported a family history for at least one of t he disorders under study, Familial coronary artery disease was most co mmonly reported (29% of participants), followed by noninsulin-dependen t diabetes (14%). Qualitative characterization of disease susceptibili ty was also accomplished using family history data, For example, occur rence of different cancers within pedigrees was suggestive of familial cancer syndromes, and clustering of noninsulin-dependent diabetes and cardiovascular disease suggested an insulin resistance syndrome, Depe nding on the specific disease, 5 to 15% of at-risk individuals had a m oderately increased risk (2 to 5 times the population risk), and appro ximately 1 to 10% had a high risk (absolute risks approaching 50%), Fa mily history reports of common, chronic disease are prevalent among th e population at large, and collection and interpretation of comprehens ive family history data is a feasible, initial method for risk stratif ication for many preventable, chronic conditions, These findings may h ave important implications for disease prevention and management. (C) 1997 Wiley-Liss, Inc.