By Michelle Zimmerman, Previvor Edge CEO
Cancer is notorious for a reason. It’s one of the toughest diagnoses we face, and it’s common—40% of Americans will be diagnosed in their lifetime, and for cancers like breast and colorectal, the age of onset is trending earlier. Yet many people reach adulthood, and even midlife, without a clear understanding of their own cancer risk.
One of the simplest, most overlooked places to begin building that understanding is your family history.
Cancer often runs in families—not just in our genes, but in our patterns. Many cancers, such as breast, ovarian, colorectal, prostate, and pancreatic, have well-established hereditary components. In fact, 36% of Americans have a first-degree family history of cancer, which should prompt deeper evaluation. But in reality, it often doesn’t.
Family History: The Starting Point That Most Miss
Only 25% of people with a family history who need an early colonoscopy actually receive one, and 85% of people whose family history suggests they should get genetic testing never do. As a result, 90% of people discover they have a genetic risk only after a cancer diagnosis.
These gaps don’t exist because science is missing, they exist because the tools we have aren’t consistently used, and because no one ever connected the dots in the first place.
Genes Aren’t the Whole Story
Lifestyle and metabolic health often run in families too. We eat similarly, move similarly, and manage stress in similar ways. Even spouses tend to share metabolic patterns. An oncologist recently told me, “If one partner has lifestyle-related risk, the other usually does too.”
Metabolic factors like insulin resistance, inflammation, visceral fat, alcohol patterns, and hormonal balance meaningfully influence cancer risk. When hereditary risk and metabolic patterns cluster together in families, the need for tailored prevention becomes even clearer.
The evidence is startling: if we properly implemented the strategies we already know work to prevent and detect cancer, we could reduce cancer cases by up to 40% and prevent roughly half of cancer-related deaths.
Talk About Cancer During the Holidays
The holidays offer a rare moment when multiple generations are spending time together in the same room—and a prime opportunity to discuss family history.
Family members often hold pieces of information—stories, memories, ages, diagnoses—that have never been shared with clinicians. When you put those pieces together, patterns emerge that can shape screening decisions and preventive strategies in meaningful ways.
We’re not advocating turning celebrations into medical discussions, but doing what it takes to ensure you have as many more moments that matter, just like these.
How to Start the Conversation (Gently)
Talking about cancer can be emotional. For some families, the experiences are recent and painful. For others, health simply hasn’t been a topic of conversation.
A few ways to open the door gently:
- “I’m trying to understand our family health history better. Do you remember if anyone had cancer and roughly how old they were?”
- “My doctor asked about family cancer history. Do you know if anyone ever had genetic testing?”
- “Do you remember if any relatives were diagnosed earlier than expected?”
Choose a quiet moment. Ask one or two relatives rather than an entire room. And if someone isn’t ready, that’s okay. You’re gathering context, not conducting an investigation. Once that information is assembled, you can share it with others—multiplying the impact.
You don’t need to know every detail to make progress. Even approximate ages and general descriptions are useful.
Clues to look for include:
- Repeated cancers on one side of the family
- Cancer diagnosed at younger-than-expected ages
- Multiple relatives with breast, colon, prostate, ovarian, or pancreatic cancer
- Any relative who had genetic testing (or who probably should have)
These details can help determine whether you need earlier screening—like starting colonoscopy sooner, adding breast MRI to your routine mammography, or considering genetic testing. This information can also go beyond detection and offer options to reduce your cancer risk.
In my own family, it wasn’t until several members faced cancer that we finally sat down, documented our entire history, and shared it across generations. That one act changed prevention strategies for many of us, including me.
Early Intervention Can Change Everything
One of the clearest findings across cancer research is that early intervention saves lives. When cancer is detected early, treatment options expand, outcomes improve, and in many cases, the disease can be prevented altogether. An early diagnosis results in a 90% 10-year survival rate, compared to 5% when caught later.
Yet too many people rely on generalized screening schedules that weren’t built for their personal risk. Understanding your family history helps you know when to start, how often to screen, and what tools might be necessary beyond the basics.
Timing matters. With cancer, the point of intervention truly can be the difference between life and death. So if you find that moment, and the timing feels right, ask that question and learn more. The information matters for you, your children, and your family.