PHSSR Policy Roadmaps for Acting Early on NCDs Synthesis Report 2025

47 Acting early on NCDs The Partnership for Health System Sustainability and ResilienceDigital infrastructure to support sophisticated risk assessment appears under-developed across all eight countries. Only Greece and Poland mention beginning to use digital systems for population outreach, though neither has developed algorithms to personalise screening based on evolving risk profiles. The absence of integrated data systems means that risk assessment occurs in isolation – a cardiovascular risk score doesn’t inform cancer screening intensity, despite shared risk factors. Dynamic risk assessment that updates as new information becomes available remains aspirational rather than operational. Evidence for systematic use of validated risk tools is limited in the available documentation, suggesting that countries continue to rely more heavily on age-based criteria for screening programmes rather than standardised risk assessment protocols. This represents missed opportunities for efficiency and effectiveness, as blanket age-based screening may both over-screen low-risk individuals and under-screen younger people at elevated risk. Opportunistic detection While systematic screening programmes represent the most visible component of early detection strategies, much early identification happens outside these formal structures: every primary care encounter offers potential for early detection: checking blood pressure regardless of presentation, assessing cardiovascular risk during minor illness consultations, or noting early symptoms that patients haven not yet recognised as significant. For NCDs, where pathological changes are either ignored or develop silently over years before clinical presentation, it is vital that this broader opportunistic detection pathway reaches populations who do not participate in formal screening programmes. What matters most is not the pathway to testing but ensuring that all populations have equitable access to early detection, whether through organised programmes or routine care. This window for early identification determines whether conditions remain manageable through lifestyle modification and simple treatments or progress to irreversible complications requiring complex interventions. The potential and scope of primary care diagnosis Several countries have recognised the critical importance of expanding diagnostic capabilities in primary care settings. Poland’s coordinated care initiative, implemented since 2018, represents a shift toward chronic disease management and early detection at the primary care level (Karasiewicz et al., 2020). As part of this reform, primary care physicians gained expanded competencies to use diagnostic tests that previously required specialist referral. This expansion acknowledges that primary care, as the first point of contact for most patients, is ideally positioned to identify NCDs early when interventions are most effective. Japan emphasises the critical role of primary care physicians in conducting comprehensive risk assessments by combining regular health checkup results with risk assessment tools. Primary care physicians are particularly important for preventing and detecting lifestyle-related diseases such as diabetes and hypertension, determining when specialist referral is necessary (JDS, 2018; JPNHS, 2019). This gatekeeping and triage function ensures appropriate use of specialist resources whilst maintaining continuity of care. Point-of-care testing plays a crucial role in primary care practices. The ability to conduct on-site diagnostics, such as blood sugar tests, cholesterol panels, and basic heart function evaluations, means patients can get their results and start treatment within a single appointment, eliminating the stress of waiting days or weeks for answers. This rapid turnaround is especially beneficial when managing conditions that require behavioural changes, as patients tend to be more motivated to modify their diet or exercise habits when they receive immediate feedback rather than delayed test results.