Screening for chronic disease in Primary Health Care: A critical analysis in light of the risk society

Abstract

Screening is widely promoted in Primary Health Care (PHC) as a strategy for the early detection of non-communicable chronic diseases, grounded in the promise of anticipating and mitigating risks. Drawing on Ulrich Beck’s risk society theory, this qualitative and exploratory study analyzed five regulatory documents — one federal and four municipal ( from São Paulo) — that govern this practice within PHC. These policies reinforce screening as a central component of health management, emphasizing targets, standardized protocols, and multiprofessional work. However, they fail to critically examine the risks involved. From Beck’s perspective, although screening is preventive in intent, it can generate adverse effects such as overdiagnosis, medicalization, and iatrogenesis, intensifying technical control over life. The creation of categories such as pre-diabetes and pre-hypertension illustrates how screening redefines the boundaries between health and disease, expanding the demand for care while reducing professional autonomy. The analysis reveals that this practice incorporates self-produced risks and challenges the notion of safety and predictability. It concludes that the centrality of screening in health policies must be reconsidered, recognizing its limitations and fostering more critical and reflexive approaches to care management.