A Value-Based Evaluation Framework for Guiding the Adoption and Scale-Up of Cancer Genomics Interventions

Cancer imposes a substantial burden characterized by high morbidity and mortality, reduced quality of life, and increased healthcare costs. This burden is expected to rise due to aging populations and persistent exposure to risk factors. Although emerging cancer technologies hold promise for improving clinical and economic outcomes across the care continuum, translating research findings into routine clinical practice remains a major bottleneck. The European Commission has prioritized addressing this challenge by fostering the rapid adoption of safer and more effective interventions. As part of its strategic plan, the European Union (EU) has launched research and innovation initiatives aimed at integrating cancer genomic technologies into public health and clinical systems. The CAN.HEAL evaluation framework presents a structured approach to classifying innovative cancer-related interventions by maturity level and to guide researchers and decision-makers in supporting adoption and scale-up efforts.

The evaluation framework was developed within the CAN.HEAL consortium, under the EU strategic cancer initiative that funded this research and innovation action, and agreed upon a consensus-based, iterative methodology including the stakeholders' perspectives. Key steps included landscape analysis, identification of key actions, structured discussions, expert consultations, and pilot testing of the assessment tool. The selected dimensions - grounded in equity, early health technology assessment, and innovation adoption principles - were hierarchically organized into subdomains, domains, and three overarching dimensions. A two-step scoring system was used to assess each key action across planning/definition and execution stages, with weighted final scores. The CAN.HEAL evaluation framework defines three adoption readiness levels, ranging from implementation at the healthcare provider level to integration across multiple healthcare systems. A structured 71-key action assessment tool, organized into three dimensions, was used to determine each intervention level: (1) equity - capacity building, research equity, and access; (2) impact assessment - early clinical development, cost considerations, and broader value; and (3) implementation, adoption, and scale-up readiness - desirability, feasibility, and viability from developer and adopter perspectives, including reimbursement pathways.

The CAN.HEAL evaluation framework is designed to offer a systematic, evidence-informed approach to assessing the adoption readiness of cancer-related innovations. Further validation in cross-border, real-world settings is needed to ensure practical utility and scalability.