The risk experience: the social effects of health screening and the emergence of a proto-illness

Sociol Health Illn. 2015 Sep;37(7):973-87. doi: 10.1111/1467-9566.12257. Epub 2015 Apr 24.


Those who undergo health screening often experience physical and emotional effects as a result of the screening process. However, the effects of health screening go beyond these physical and mental complications, often having profound social effects for those who are screened. This study explores the social implications of health screening for people who undergo it and are designated as being at risk for potential disease. Through a qualitative analysis of the experiences of individuals with elevated cholesterol levels and men with elevated prostate-specific antigen (PSA) levels, this research offers a description of the experience of being at risk, identifying three primary components: increased medical contact, a restructuring of everyday routines and altered social relationships. Whereas the at-risk health status engendered by current clinical approaches to screening and surveillance has been characterised as proto-disease, this study develops a companion definition of proto-illness to characterise the social experience of life with an identified health risk. Those who are at risk act in ways that are similar to those who are ill. The concept of proto-illness implies that the experience of risk is parallel to the experience of illness and contributes to the sociology of medical screening by establishing a much needed bridge between the two experiences.

Keywords: risk; screening; uncertainty.

MeSH terms

  • Adult
  • Aged
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / prevention & control
  • Female
  • Grounded Theory
  • Health Status*
  • Humans
  • Illness Behavior
  • Interviews as Topic
  • Male
  • Mass Screening / methods
  • Mass Screening / psychology*
  • Middle Aged
  • Prostate-Specific Antigen / analysis
  • Prostatic Neoplasms / diagnosis
  • Prostatic Neoplasms / prevention & control
  • Risk Assessment / methods*
  • Sociology, Medical*


  • Prostate-Specific Antigen