7: No. 1, January 2010
Familial Risk for Chronic Disease and Intent to Share Family History With a Health Care Provider Among Urban Appalachian Women, Southwestern Ohio, 2007
The figure shows how people are stratified into high,
moderate, or average risk categories on the basis of their familial risk for a
A person is considered at high risk if he or she meets any of the following: 1.
Premature disease in a first-degree relative. Premature disease is
considered coronary artery disease onset age 55 years or younger in men or
65 years or younger in women; stroke, type 2 diabetes, colon or prostate
cancer onset 50 years or younger; breast, ovarian, or endometrial cancer
onset premenopausal or 50 years or younger. 2. Premature disease in a
second-degree relative (coronary artery disease only). 3. Two affected
first-degree relatives. 4. A first-degree relative with late/unknown onset
of disease and an affected second-degree relative with premature disease
from the same lineage. 5. Two second-degree maternal or paternal relatives
with at least 1 having premature onset of disease. 6. Three or more affected
maternal or paternal relatives. 7. “Moderate risk” family history on both
sides of the pedigree.
A person is considered at moderate risk if he or she meets either of the
following: 1. A first-degree relative with late or unknown disease onset. 2.
Two second-degree relatives from the same lineage with late or unknown
A person is considered at average risk (general population risk) if he
or she meets any of the following: 1. No affected relatives. 2. Only 1 affected
second-degree relative from 1 or both sides of the pedigree. 3. No known
family history. 4. Adopted with unknown family history.
Pedigrees that demonstrate clustering of different primary cancers
consistent with a family cancer syndrome are considered high risk. Pedigrees
that demonstrate clustering of cardiovascular diseases and type 2 diabetes
consistent with syndrome X are considered high risk.
Figure. General familial risk stratification guideline. Adapted from
Scheuner et al (8). Reprinted with permission of John
Wiley & Sons, Inc.
Return to article