The Future of Cancer Knowledge Management in Europe: A Participatory Foresight Study

Abstract

This study presents the results of a participatory foresight exercise conducted within the OriON Joint Action to support the long-term sustainability of cancer knowledge in Europe under the European Beating Cancer Plan (EBCP). As EU-funded cancer initiatives continue to expand, ensuring that evidence is accessible, reusable, and equitably distributed across Member States is critical for effective cancer care and control. The study explores how artificial intelligence (AI), particularly generative AI (GenAI), can support this transition from evidence to impact in cancer knowledge management. The study combined a scoping literature review, an expert survey, scenario development, and stakeholder workshops at EU and national level. Thirty key determinants organised across the DESTEP framework were identified, and prioritised by impact and uncertainty. Two critical uncertainties emerged: the inclusivity of AI systems across linguistic, cultural, and generational contexts, and the extent to which equity and justice are embedded in AI governance frameworks. These uncertainties informed four future scenarios, ranging from highly coordinated and inclusive systems to fragmented and weakly governed environments. Stakeholder workshops highlighted opportunities and challenges of GenAI for knowledge management of EBCP evidence. Across scenarios, participants consistently identified trust, human oversight, interoperability, and continuous capacity-building as essential conditions for sustainable and equitable uptake. A Belgian workshop further identified national priority actions, including investing in multilingual and context-aware AI functions, shared quality and interoperability standards, strengthened stakeholder engagement, and AI literacy across sectors. These findings will inform a future foresight exercise under the eCAN+ Joint Action focusing on data exchange, collaboration, and inclusive AI governance among cancer centres.