Background: The International Agency for Research on Cancer (IARC) developed the Workforce and Equipment Needs Estimator (NEEDS), a global decision-support platform for evidence-informed cancer screening planning based on epidemiological data and modelling approaches. The platform integrates population data, service capacity, and workforce availability to estimate resource requirements across different organizational and epidemiological scenarios. In Brazil, cervical cancer remains a major public health challenge, with regional disparities and barriers to transitioning from opportunistic to organized screening. Despite advances in evidence and policy, planning and scale-up are constrained by limited integration of epidemiological data, service capacity, and workforce availability. NEEDS-BR represents a tailored tool to support screening capacity planning and scenario analyses within the Brazilian Unified Health System (SUS).
Objectives: To adapt and apply the IARC-developed NEEDS tool to the Brazilian context for planning cervical cancer screening within the SUS. The tool integrates national demographic, epidemiological, and administrative health data, enabling estimation of procedure volumes, workforce, equipment requirements, and comparison of projected needs with observed service delivery across geographic levels, including real-time parameter adjustment and simulation of alternative screening scenarios.
Methods: NEEDS-BR was developed as a country-specific adaptation of the IARC NEEDS decision-support platform and implemented as an interactive digital tool integrating the modelling framework with national epidemiological and administrative health data. Brazilian demographic data were incorporated with hierarchical geographic disaggregation (state, macroregion, health region, municipality) to support planning aligned with the organization of the SUS, further stratified by private health insurance coverage to estimate needs for the population dependent on the public system. National outpatient data from the Brazilian Outpatient Information System (SIA/SUS) were integrated to capture screening-related procedure volumes, enabling comparison between estimated needs and observed service delivery. Key model parameters, informed by scientific literature and Brazilian data, are fully adjustable within the tool to support scenario analyses across different epidemiological profiles, organizational settings, and screening strategies.
Results: The adapted NEEDS-BR tool provides interactive dashboards that visualize differences between current service provision and projected needs across geographic levels and screening strategies. Scenario analyses demonstrate substantial variation in required examination volumes, workforce, and service capacity when comparing cytology-based and HPV-based screening approaches and when modifying coverage targets and productivity assumptions. The tool highlights regional heterogeneity and planning gaps, supporting identification of opportunities for optimization of existing resources and more efficient allocation of new investments. For example, in São Paulo State, assuming the Brazilian HPV-based screening protocol (HPV16/18-positive women referred to colposcopy and other oncogenic types triaged by cytology) with 70% coverage, projected colposcopy needs range from about 114,000 examinations for the total population to 65,000 for the SUS-dependent population per year. In this scenario, observed biopsy volumes would be sufficient to meet only 44% of the estimated need among SUS-dependent women, and 25% of the total population.
Conclusions/Implications: The tool contributes to more organized, equitable, and sustainable screening programs tailored to local contexts. This experience demonstrates the feasibility of developing country-specific decision-support tools from the IARC global NEEDS platform, supporting the translation of global recommendations into actionable national cancer control strategies.