Family Health History: What to Ask at Thanksgiving, and What Each Answer Changes

The details that change your care are usually sitting at the same table: who had what, and how old they were when it was found. Clinicians use those two facts to decide when screening starts, which tests you need and whether genetic counseling makes sense. CDC says having a close relative with a disease can at least double your own risk of it.

Start with close blood relatives on both sides of the family: parents, brothers and sisters, half-siblings, children, grandparents, aunts, uncles, nieces and nephews. That is CDC's list, and it is the one clinicians work from.

For each person, you want three things:

• The conditions they have or had. Cancer (which kind), high blood pressure, diabetes, heart attack, stroke, kidney disease, glaucoma, sickle cell disease or trait, and mental health conditions.
• How old they were when each one started. CDC notes that an approximate age is still useful, so "in his forties" is worth writing down.
• For relatives who have died, the cause and their age at death.

Nobody wants a clipboard at dinner. One or two of these, asked in a quiet moment, usually opens the rest:

• "Has anybody in the family had cancer? What kind, and how old were they?"
• "Who has pressure or sugar? Is anybody on dialysis?"
• "Did anybody have a heart attack or a stroke young?"
• "Does anybody have glaucoma, or lose their sight as they got older?"
• "Does anybody know if they carry sickle cell trait?"
• "What did Granddaddy pass from, and how old was he?"

Elders often use their own words: "sugar" for diabetes, "pressure" for high blood pressure, "a growth" or "female trouble" for a cancer nobody named out loud. Write down the words they use, then ask a gentle follow-up. Going first helps too. Sharing your own blood pressure reading or your last screening makes it easier for an uncle to share his.

For people at average risk, the U.S. Preventive Services Task Force recommends colorectal cancer screening starting at 45. Family history moves that date. The U.S. Multi-Society Task Force on Colorectal Cancer advises that if a parent, brother, sister or child had colorectal cancer or an advanced polyp before 60, or two of them had it at any age, you get a colonoscopy every five years starting at 40, or 10 years before the youngest relative's diagnosis, whichever comes first. If your mother was diagnosed at 46, that means 36. Our guide to colon cancer screening covers the test options.

The American Cancer Society revised its guidance on November 12, 2026: Black men should begin screening at 45 and get a PSA test every year through 69. Men of any background with a father, brother or son who had prostate cancer also start at 45, and ACS advises testing every year if that relative was diagnosed before 65 or more than one relative has had it. Before you start, ACS says your clinician should walk you through what the test can and cannot tell you. See PSA levels by age.

The Task Force recommends a mammogram every two years for women 40 to 74. Family history adds a second step: it recommends that primary care clinicians assess women with a personal or family history of breast, ovarian, tubal or peritoneal cancer using a brief familial risk tool, and that women who screen positive get genetic counseling and, if indicated, genetic testing. If breast or ovarian cancer shows up on either side of your family, including your father's, ask for that assessment by name. Read more on triple-negative breast cancer, which is more common in Black women.

The National Cancer Institute lists the patterns that point toward an inherited cancer syndrome and a visit with a genetic counselor:

• A cancer found at a young age, for example colon cancer before 50.
• Several parents, siblings or children with the same type of cancer.
• A rare cancer, for example breast cancer in a man.
• A relative who has tested positive for an inherited gene change that raises cancer risk.

Clinicians treat heart disease in a father or brother before 55, or in a mother or sister before 65, as a premature family history and a risk factor in its own right. That is the definition in the National Heart, Lung, and Blood Institute's cholesterol guideline. If it applies to you, it belongs in the conversation about your cholesterol and blood pressure, even if your own numbers look fine.

CDC lists having a parent or sibling with type 2 diabetes as a risk factor. Ask about an A1C or fasting glucose at your next visit, and see what reverses prediabetes.

The National Institute of Diabetes and Digestive and Kidney Diseases lists a family history of kidney failure as something that makes kidney disease more likely, and it asks people with kidney disease to tell relatives to get tested. Variants in a gene called APOL1, found primarily in people of African ancestry, raise kidney risk, though NIH researchers note that most people with two variants never develop kidney disease. Our guide to kidney disease and APOL1 explains the tests.

The National Eye Institute lists being African American and over 40, and having a family history of glaucoma, as risk factors. If you are at higher risk, it recommends a comprehensive dilated eye exam every 1 to 2 years. Glaucoma takes side vision first, with no pain, so a relative who "just lost his sight" is worth asking about. More in our glaucoma screening guide.

About 1 in 13 Black babies is born with sickle cell trait, according to CDC. Trait itself is not the disease, but it matters when two people with trait have children: each pregnancy has a 1 in 4 chance of sickle cell disease, a 1 in 2 chance of trait, and a 1 in 4 chance of neither. A simple blood test tells you whether you carry it. See sickle cell trait and planning a family.

CDC links a free web tool, My Family Health Portrait, that organizes the information and lets you save or print it. A notebook page or a note on your phone works too. What matters is that it exists, that you update it whenever you learn something new, and that you bring it to your next visit. CDC is clear on the gaps: even if you do not know your whole history, share what you do know. If you were adopted or do not know one side of your family, say that too; it tells your clinician which questions to ask instead.

A family history only helps if a clinician acts on it. If yours brushes it off, it is reasonable to look for one who will. You can ask for a Black doctor, or search our directory of Black clinicians by city and specialty.