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Family history of disease, and when it changes your care

A family history matters most when several close relatives on one side had the same condition, or when relatives were diagnosed unusually young, and then it can change when screening starts or lead to genetic testing. A GP appointment at The Wellness, £150, takes the history across both sides of your family and tells you whether anything should change.

What it costs: A GP appointment to take your family history is £150.
How soon: Appointments from the next day, seven days a week.
How to begin: Request a GP appointment, and ask your relatives a few questions first.

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4 min readWritten and reviewed by the clinical team at The Wellness. Last reviewed 15 October 2026

Why family history matters

Your family history is one of the simplest and most useful pieces of health information you have. It can point to an inherited risk, and it can just as often show that a relative’s illness does not change your own care.

Common conditions often appear in families without a strong inherited cause. Heritable factors account for about 35% of bowel cancer risk, and almost 30% of people in the UK have a family history of bowel cancer, most of whom are not at high risk [1]. The details are what tell these apart.

How a doctor takes a family history

A useful history covers first-degree relatives, meaning parents, brothers, sisters and children, and second-degree relatives, meaning aunts, uncles, grandparents, nieces and nephews, on your father’s side as well as your mother’s [2]. For each person with a condition, the doctor asks the age at diagnosis and where a cancer started. Whether anyone had more than one cancer, or cancer in both breasts, matters too [2].

Ancestry also matters, since women with Jewish ancestry are around 5 to 10 times more likely to carry a BRCA1 or BRCA2 gene change than women in non-Jewish populations [2]. In the US, the Preventive Services Task Force advises using a brief risk assessment tool for women with a personal or family history of breast or ovarian cancer, or an ancestry linked to BRCA changes, and genetic counselling when that tool is positive [3].

Breast and ovarian cancer

One relative diagnosed with breast cancer after the age of 40 usually means a risk close to the general population, in most cases less than a 3% chance over 10 years at age 40 [2]. NICE advises specialist referral for patterns such as a mother or sister diagnosed before 40, a father or brother with breast cancer at any age, 2 close relatives with breast cancer, or breast and ovarian cancer on the same side of the family [2].

Women at moderate risk aged 40 to 49 are offered yearly mammograms, and those at higher risk may be offered MRI and genetic testing through a specialist service [2].

Heart disease and cholesterol

A parent, brother or sister who had a heart attack or similar event before 60 is a reason to check your cholesterol. NICE advises suspecting familial hypercholesterolaemia, an inherited cause of very high cholesterol, when total cholesterol is above 7.5 mmol/L or there is a family history of coronary heart disease before 60 [4].

When a gene change is confirmed, NICE recommends cascade testing, offering DNA tests to close relatives and, where possible, more distant ones [4]. Your family history is also part of routine heart risk assessment, and a total cholesterol above 9.0 mmol/L calls for specialist assessment even without one [5].

Bowel cancer

UK guidance defines moderate family risk as one first-degree relative diagnosed with bowel cancer under 50, or 2 first-degree relatives diagnosed at any age, and advises a one-off colonoscopy at 55 [1]. A family with at least 3 affected first-degree relatives across 2 generations is high risk, with colonoscopy every 5 years from 40 to 75 [1].

Who it is not for, and the limits

A family history assessment is for people without symptoms. If you notice a breast lump, bleeding from the bowel, a lasting change in bowel habit or chest pain on exertion, you need an examination, and a GP appointment is the place to start.

Genetic testing helps most when the family history points to it. The US task force recommends against routine genetic testing for women whose family history is not linked to BRCA changes [3], and more screening brings its own false positives and further tests [3]. Family memories are often incomplete, so a doctor treats the history as a guide and updates it as you learn more. For chest pain at rest or sudden breathlessness, call 999 in the UK or the local emergency number [6].

Questions to ask your relatives

A few conversations before your appointment make the history far more accurate, and NICE notes that asking relatives helps [2].

Which conditions did each close relative have, especially cancer, heart disease, diabetes or dementia?
How old were they when it was diagnosed?
For a cancer, where in the body did it start, and was there more than one?
Has anyone had genetic testing, and what did it find?
Which side of the family are they on, and where did the family come from?

How The Wellness can help

A GP appointment gives you time to go through your family history with a GMC registered doctor, who arranges the checks it calls for, including a specialist referral when a pattern needs one. Every result is explained by a doctor.

If genetic testing is worth discussing, our genome programmes begin with a free first call with a doctor, and a registered genetic counsellor is involved where a finding appears [7].

Questions

Which relatives count in a family history?

First-degree relatives, meaning parents, brothers, sisters and children, and second-degree relatives such as aunts, uncles, grandparents, nieces and nephews, on both your father’s and your mother’s side [2].

My mother had breast cancer. Am I at high risk?

It depends on her age and the rest of the family. One relative diagnosed after 40 usually means a risk close to average, while a diagnosis before 40 is a reason for specialist referral [2].

Should I check my cholesterol if my father had an early heart attack?

Yes. A heart event in a parent or sibling before 60 is a reason to measure cholesterol and consider familial hypercholesterolaemia [4].

When should I have a colonoscopy if bowel cancer runs in my family?

UK guidance advises a one-off colonoscopy at 55 for moderate family risk, and colonoscopy every 5 years from 40 for families at high risk [1].

Should I have genetic testing because of my family history?

Only when the pattern suggests an inherited cause. A doctor or genetic counsellor can assess this first, because testing without that pattern is not recommended [3].

Sources

Written and reviewed by the clinical team at The Wellness. Last reviewed 15 October 2026. This page is general information and not a substitute for advice from your own doctor.