Background
Colorectal Cancer (CRC) is the third most incident cancer in Colombia (8,679 new cases per year - 8.6%) for the period 2017-2021 and the third leading cause of cancer death, with the highest risk in Bogotá and the departments of Quindío, Risaralda, Valle, and Caldas. Currently, in Colombia, only fragmented opportunistic strategies exist, with minimal coverage, indicating a lack of coordination among universities, public and private healthcare service providers, territorial health authorities, and scientific associations. There are no structured spaces for public and private actors to share information, build trust, and align capabilities around a shared mission, which is particularly relevant in middle- and low-income countries where efficiency in using limited resources is critical.?
A scientific ecosystem that integrates research and operational implementation in territories, multi-level governance (public-private), and bottom-up participatory processes can transform distributed capabilities into systemic synergies. The colorectal cancer scientific ecosystem addresses these challenges through two initial missions: (1) identification of biomarkers with potential utility in CRC screening and (2) design of an organized program for CRC screening and early detection.?
Objectives
Contribute to the generation of knowledge, research, development, and innovation for the creation of sustainable public policies aimed at preventing and detecting colorectal cancer early in Colombia, 2023-2026.?
Methodology
This scientific ecosystem is led by the National Cancer Institute (INC) and comprises various actors/entities such as Universidad El Bosque, Sociedad de Cirugía de Bogotá--Hospital de San José, Hospital Universitario San Ignacio, S.E.S. Hospital Universitario de Caldas, Centro de Diagnóstico Clínico (CDC), scientific associations, and territorial allies interested in generating knowledge, research, development, and innovation in colorectal cancer.?
The program adopts the Mission-Oriented Research and Innovation Model and the Transformative Innovation framework, guiding its actions through a roadmap that considers scope, baseline, vision, innovation trajectories, policies, and continuous learning. In this context, instruments are applied for the diagnosis and measurement of capabilities among actors, with the main objective of jointly building this roadmap, supported by a solid evidence base through a bottom-up process that promotes broad participation from health system actors, academia, and civil society.?
Results
The program achieved the establishment of an interactive governance platform facilitating communication among involved actors. It conducted participatory qualitative analyses to identify system facilitators and barriers and consolidated epidemiological and operational baselines in three departments. Achievements also include reducing territorial inequities in early detection access, generating evidence for a potential national screening program, developing new biomarkers and quality guidelines, producing high-impact publications, training postgraduate professionals, and enhancing Colombia's role as a regional reference in comprehensive CRC control.?
Conclusions
This scientific ecosystem represents an innovative model of public-private-academic articulation that demonstrates how middle- and low-income countries can consolidate international quality research by leveraging existing installed capacity, collaborative markets for specialized services, and multi-level governance. The ecosystem's structure, with INC leadership, differentiated roles for actors, bidirectional information flows, and continuous learning mechanisms, constitutes a transferable institutional innovation product to other oncological pathologies and Latin American contexts.?
 
Project funded by the Ministry of Science, Technology and Innovation of Colombia