Title: A Co-creation Laboratory as a Transformative Innovation for Comprehensive Cancer Control in Colombia

Background: The National Cancer Institute of Colombia (INC) implemented the Co-creation Laboratory for Innovation as a transformative innovation experiment aimed at strengthening institutional capacities, fostering collaborative partnerships across the innovation ecosystem, and generating solutions for comprehensive cancer control. This initiative responded to the need to overcome limitations of routine practices in oncological care, which have historically constrained the effective adoption of innovative approaches. Conceived as a systemic and participatory space, the Laboratory integrates science, technology, and innovation while promoting interaction among patients, health professionals, academia, industry, and government. Its design aligns with the principles of Transformative Innovation Policy and the Sustainable Development Goals

Objectives: To develop and implement a Co-creation Laboratory for Innovation at the National Cancer Institute of Colombia (INC) as a demonstrative R&D&I unit aimed at strengthening institutional capacities and generating innovative solutions for comprehensive cancer control in Colombia, through the active participation of patients, caregivers, health professionals, and other ecosystem actors, as well as the design of tools for innovation management and capacity assessment with national scalability potential.

Methods: The Co-creation Laboratory was implemented as a demonstrative R&D&I unit using a systemic and transformative methodological approach. Two complementary approaches were adopted: the Minimum Viable Innovation System (MVIS), based on agile cycles of needs identification, ideation, prototyping, and solution validation; and transformative innovation, which incorporated tools such as Multicriteria Mapping and the deliberate inclusion of patients, caregivers, and other actors in decision-making processes. The strategy followed NTC 5801:2018 and the Integrated Planning and Management Model, assessing institutional innovation capacities with a five-level maturity model. Between 2023 and 2025, the Laboratory enabled projects across three areas: education, prototyping, and digital transformation.

Results: In the educational domain, immersive virtual reality experiences were implemented to promote colorectal and breast cancer screening in five regions of the country. In clinical prototyping, solutions were developed for radiology and brachytherapy, as well as 3D printing applications for facial prostheses (Face3D). In digital transformation, the conversational assistant MonINC was designed and implemented to support patients undergoing chemotherapy, alongside artificial intelligence algorithms for digital mammography and generative AI experiments aimed at improving adherence to clinical guidelines. Additional outcomes included software for dose monitoring and remote image quality control. Institutional capacity assessment revealed an intermediate maturity level (60–67%) and identified critical gaps in digital transformation, change management, and security, which informed targeted institutional improvement plans.

Conclusions / Implications: These results demonstrate the viability of the Co-creation Laboratory for Innovation as an operational R&D&I unit embedded within a national cancer institution, with tangible

impacts on institutional capacity strengthening and organizational culture transformation. They further highlight its potential to scale into a National Network of Health Co-creation Laboratories, offering a replicable model for middle-income country contexts seeking systemic transitions in cancer control. This approach contributes to advancing equity, strengthening health system resilience, and reducing the cancer burden through the implementation of applied, participatory innovation.