ONCODIR – Evidence-based Participatory Decision Making for Cancer Prevention through implementation research

Project Information

ONCODIR

Grant agreement ID: 101104777

DOI

10.3030/101104777

EC signature date 24 April 2023

Start date 1 June 2023

End date 30 November 2026

Funded under

• Health

Total cost

€ 7 893 636,25

EU contribution

€ 7 893 636,25

Coordinated by

ETHNIKO KENTRO EREVNAS KAI TECHNOLOGIKIS ANAPTYXIS
Greece

Periodic Reporting for period 2 - ONCODIR (ONCODIR – Evidence-based Participatory Decision Making for Cancer Prevention through implementation research)

Reporting period: 2024-12-01 to 2025-11-30

Summary of the context and overall objectives of the project

ONCODIR advances evidence-based primary cancer prevention through AI-powered personalised approaches. By integrating expertise in health policy analytics, social and behavioural sciences, AI-driven multi-omics, and retrospective data analysis, the project seeks to redefine colorectal cancer (CRC) prevention to reduce incidence, improve early detection, and guide future policy. Its overarching objective is to strengthen public health across Europe by tackling structural barriers and inequalities that hinder participation in CRC prevention programmes and by promoting equitable and affordable access within and across EU countries. To secure lasting impact, ONCODIR assesses cost-effectiveness and affordability while exploring financial models that support accessible and efficient CRC prevention.

The project analyses barriers and facilitators to CRC prevention uptake through a pan-European study and a meta-analysis of CRC risk factors. These findings underpin a risk-stratification approach that enables targeted interventions and equitable access. ONCODIR also provides trustworthy personalised recommendation services for primary prevention and behavioural change, co-created through participatory workshops and Living Labs with citizens, clinicians, and policymakers.

In parallel, ONCODIR develops an adaptable implementation framework that integrates structural and behavioural measures to enhance existing programmes, with focus on lifestyle, nutrition, and social determinants. Drawing on economic and sociological insights, it proposes inclusive strategies to optimise interventions. A technological ecosystem based on trustworthy AI and privacy-preserving principles supports delivery, increases awareness, and empowers evidence-based decision-making.

Sustainable uptake is promoted through practical pathways for integrating cost-efficient interventions into regional and national health strategies. Validation is ensured via three Laboratory Integration Tests (LITs) and three Large-scale Intervention Pilots (LIPs) across five EU Member States, engaging healthcare professionals and stakeholders to facilitate long-term adoption.

Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far

All ONCODIR tools — NELI (citizen app), DEPO (clinical dashboard), DELI (policy analytics tool), PYRAMID (risk stratification engine), APPO (trustworthy AI module), and OFEN/Data Fusion — have been fully integrated via the ONCODIR Data Warehouse (DWH). The system operates through secure APIs and Kafka-based real-time flows, achieving deployment stability and pilot readiness. LIT-03 was successfully completed, validating the multisectoral policy model and the DELI dashboard under real-world conditions. A regional analytics tab and structured stakeholder consultations further strengthened adoption readiness.

Substantial scientific progress was achieved through the Participatory Policy Implementation Research Framework, based on a validated Multi-Criteria Decision Analysis (MCDA) model, which prioritised 26 CRC policy interventions. Sensitivity analysis confirmed ranking robustness, with Long-Term Impact and Effectiveness identified as key criteria, establishing a transparent and replicable EU-level methodology. Four country profiles (Greece, Lithuania, Romania, Spain) were developed to map regulatory contexts and system constraints, alongside an Activity Guide and Regulatory Roadmap template to support national uptake.

A systematic review of economic evaluations informed the Lithuanian Health Technology Assessment (LIP-03), combining short-term decision-tree modelling with long-term Markov projections using QALYs—among the first HTAs assessing AI-supported digital CRC primary prevention tools. Behavioural evaluation of NELI, based on an adapted Technology Acceptance Model, showed positive links between prolonged use and perceived health improvement, confirming adoption potential.

Stakeholder engagement was also reinforced. A total of 244 validated end-user requirements were finalised across five tools, ensuring pilot readiness. ONCODIR strengthened its role within the Prevention & Early Detection EU Cluster (D2.5 D7.7) organised Living Labs and high-level policy events, including in Valencia and the Lithuanian Parliament, and advanced exploitation planning through analysis of five Key Exploitable Results (KERs).

Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far)

During RP2, ONCODIR advanced beyond conventional CRC prevention by deploying an integrated, AI-supported ecosystem that combines risk stratification, participatory policymaking, economic modelling, and trustworthy AI governance. The project is transforming CRC prevention through AI-driven tools, sustainable financial mechanisms, and coherent policy frameworks, supported by strong collaboration among researchers, clinicians, policymakers, and citizens. A key milestone was the launch of the Open Data Bank, offering structured access to clinical guidelines, scientific evidence, and policy recommendations.

ONCODIR’s AI environment promotes fairness and transparency by identifying potential biases in healthcare data and decision processes. It enables policymakers to detect CRC disparities across Europe, including age- and gender-specific trends, and strengthens evidence-based decisions. In parallel, Health Technology Assessment activities assess the cost-effectiveness and scalability of ONCODIR’s solutions within different healthcare systems. The project also proposes innovative financial schemes to sustain prevention programmes and awareness efforts, alongside a replicable regulatory roadmap and targeted training for healthcare professionals and policymakers across the EU.

ONCODIR’s expected impact includes empowering citizens with affordable, evidence-based prevention services; supporting healthcare professionals with improved clinical guidance and tools; reinforcing data-driven CRC prevention policies; and fostering sustainable innovation to enable broad, cross-sectoral uptake of its solutions.