History taking is an art . It is one of the first skills taught in clinical skills training of a medical student. With proper history taking one can actually catch the diagnosis even before investigations are done. Also it gives us vital information which alters the treatment plan entirely. But what’s the actual role of Race and ethnicity when history is taken? We would know in this article.
Some races are more prone to get certain diseases, the disease along with the race are :-
1) Breast cancer
Ethnicity significantly influences breast cancer risk, stage of diagnosis and outcomes. Addressing these disparities requires focused efforts in diagnosis and prevention across diverse communities.Black women: Black Caribbean and African women are up to twice as likely to be diagnosed with late-stage, high-grade breast cancer compared to white women.
South Asian women: Women of South Asian descent, including those from Indian, Bangladeshi, and Pakistani backgrounds, have a higher chance of being diagnosed with late-stage breast cancers.
2)Beta-Thalassemia & Microcytic Anemias: Beta-thalassemia trait is highly prevalent in India, with certain communities (such as the Lohanas, Bhanushalis, Sindhis, and Punjabis) carrying a higher carrier frequency. During history taking, identifying microcytic anemia in these groups warrants checking a hemoglobin electrophoresis before reflexively prescribing iron, which could cause iron overload.
3) Nasopharyngeal Carcinoma (NPC): While rare in the rest of India, NPC is highly prevalent in states like Nagaland, Mizoram, and Manipur. When taking a history from a Northeast Indian patient presenting with chronic unilateral nasal obstruction, epistaxis (nosebleeds), or a persistent neck lump, NPC must be high on your differential.
So, a meticulous history taking, with special emphasis on race and religion is an important part of understanding the patient .
Do you know any other diseases where it is more common for a specific community or religion ?