Background: Brazil continues to face persistent challenges in cancer screening, including reliance on opportunistic practices, fragmented health information systems, and low adherence. To address these gaps, SisConeCta-SP was developed as a digital platform to strengthen organized screening for breast and cervical cancer. The system integrates multiple data sources to identify target populations and monitor individuals across stages of care. This innovation is part of the Cancer Control in the State of São Paulo (ConeCta-SP): From Knowledge to Action project, led by the Fundação Oncocentro de São Paulo with support from the State Health Secretariat and the São Paulo Research Foundation.
Objective:To detail the development, pilot implementation, and early scale-up of SisConeCta-SP, a digital health tool designed to facilitate the transition toward organized, population-based cervical and breast cancer screening within São Paulo’s public health system.
Methods: SisConeCta-SP was designed using a microservices architecture, integrating state-level administrative screening databases for cervical and breast cancer (SISCOLO, SISMAMA, SISCAN) with municipal registries to identify women in recommended age groups. Individual screening histories were consolidated using record linkage techniques. National screening guidelines were translated into system rules through applied research, enabling automated classification of screening status, pathway assignment, and stage-specific follow-up. The platform also includes a manual data entry interface for information not captured electronically (e.g., colposcopy and breast ultrasound results), logging invitations, and tests performed outside the public health system. All data management processes followed established security and privacy safeguards. Implementation began with a pilot in Mococa (population 67,609), involving 13 primary care units and training 21 professionals. Following the pilot, the system began scaling to other municipalities within the São João da Boa Vista Regional Health Department, covering 805,000 inhabitants.
Results: Feedback from pilot end users guided iterative refinements, improving system accuracy, usability, and workflow integration. SisConeCta-SP now features indicator panels, customizable filters, and tiered access for regional, municipal, and primary care teams. Core functionalities include generating invitation lists, visualizing examination results, and internal recall flags for individuals overdue at any screening stage. The system was expanded to 18 municipalities, achieving 90% of regional coverage as of January 7, 2026, and currently encompasses 203,441 eligible women aged 25-64 for cervical cancer screening and 104,664 aged 50-74 for breast. Integrated data revealed significant gaps: 154,404 women had never been screened for cervical cancer and 73,758 for breast. Additionally, 49,532 were overdue for Pap testing and 21,265 for mammography.
Conclusions/Implications for practice: ?SisConeCta-SP is a robust digital platform that facilitates the transition to an organized, population-based screening model for cervical and breast cancer. By integrating disparate data sources and automating guideline-driven workflows, it addresses critical gaps in primary healthcare, particularly the lack of structured monitoring. The system advances equity through targeted outreach and systematic follow-up, leveraging its capacity to identify unscreened and under?screened populations and guide strategies that expand coverage. The pilot and subsequent scale-up demonstrated technical feasibility, operational benefits in streamlining healthcare workflows, and strong potential for statewide adoption across all 645 municipalities in São Paulo, a state with a population exceeding 46 million.