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Evolutionary medicine

Update on the relevance to family practice

Correspondence to: Dr Naugler, Department of Pathology and Laboratory Medicine, Dalhousie University, 5788 University Ave, Halifax, NS B3H 2Y9; telephone 902 473-5934; fax 902 473-4113; e-mail nauglerc{at}dal.ca

OBJECTIVE To review the relevance of evolutionary medicine to family practice and family physician training.

QUALITY OF EVIDENCE Articles were located through a MEDLINE search, using the key words evolution, Darwin, and adaptation. Most references presented level III evidence (expert opinion), while a minority provided level II evidence (epidemiologic studies).

MAIN MESSAGE Evolutionary medicine deals with the interplay of biology and the environment in the understanding of human disease. Yet medical schools have virtually ignored the need for family physicians to have more than a cursory knowledge of this topic. A review of the main trends in this field most relevant to family practice revealed that a basic knowledge of evolutionary medicine might help in explaining the causation of diseases to patients. Evolutionary medicine has also proven key to explaining the reasons for the development of antibiotic resistance and has the potential to explain cancer pathogenesis. As an organizing principle, this field also has potential in the teaching of family medicine.

CONCLUSION Evolutionary medicine should be studied further and incorporated into medical training and practice. Its practical utility will be proven through the generation of testable hypotheses and their application in relation to disease causation and possible prevention.