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Knowing the medical history of you biological family is absolutely a big deal. A lot of risk factors that you might not be screening for early or frequently enough without knowing the history.
In no way does your family history replace the need for those screenings. Just because there is no history of Colon Cancer doesn’t mean you don’t need to get you colon checked out.
Your family’s history is just an indicator and can be addressed by many other means.
With certain family history they start screening earlier and can catch things at earlier stages both of which equate to better outcomes.
Genetic sequencing is a near replacement nowadays but generally is not covered and can cost a few hundred.
The frequency of recommended screenings can change based on family history. A heart scan and arterial ultrasound may not be recommended if you have no family history of heart disease and you have no indicators for it yourself. And with our shit health insurance industry you may not be able to get certain screenings paid for if your doctor isn't able to convince of their necessity, which having family history can help them do.