It is my understanding that Apple implemented a program that generates a hash of a file and compares it to a blacklist, and notifies Apple in the event of a match. It's not clear, but it appears this is only run when uploading to iCloud.

The blacklist itself is not maintained by Apple, but by the US government or a third party like NCMEC, which means Apple can't be sure content that isn't child abuse imagery hasn't made it onto the list. Perceptual hashes probably can't be abused to target non-image/video content because they're an inherently image-oriented technology.

Apple could, however cause such a program to match on different criteria with a simple update, and such a change would likely be difficult to detect. Most of us assume Apple wouldn't voluntarily do such a thing, but it's very probable that they would do it involuntarily. The US government has already attempted to compel Apple to create a tool to compromise the security of an iPhone, and might have eventually succeeded in court if they hadn't gained access by other means. That fight took place in public, but the next one might well take place in secret.