Digital ecosystems for cancer prevention: integrating citizen engagement, clinical decision support, and policy analytics

Abstract

As smart cities increasingly rely on interconnected digital infrastructures, healthcare systems must adopt secure, intelligent, and data-driven approaches capable of supporting large-scale prevention strategies and resilient public health services. Colorectal cancer (CRC) remains a major public health challenge in Europe, requiring integrated solutions that combine citizen engagement, clinical intelligence, and policy-oriented analytics. Traditional prevention approaches are often affected by fragmented data flows, limited personalization, and insufficient interoperability between healthcare stakeholders. This paper explores the role of the ONCODIR digital ecosystem in supporting intelligent and prevention-oriented healthcare infrastructures through three core components: NELI, DEPO, and DELI. NELI, a citizen-oriented mobile application, enables individuals to monitor lifestyle factors, receive personalized recommendations, and actively participate in prevention practices. DEPO provides AI-based clinical decision support capabilities that enhance medical workflows through data-driven recommendations and personalized counselling. DELI, the policy analytics dashboard, supports evidence-based governance by enabling the analysis of aggregated health indicators and intervention outcomes for public health planning. The research adopts an implementation-oriented analytical approach focused on how integrated digital platforms contribute to resilient healthcare ecosystems and multi-level decision-making within smart city environments. The study investigates how interoperable digital tools transform behavioural and clinical data into actionable intelligence while supporting stakeholder engagement, prevention efficiency, and policy coordination. The findings highlight the potential of intelligent digital health ecosystems to strengthen preventive healthcare services, improve data-driven governance, and support the development of cyber-resilient and citizen-centred smart healthcare infrastructures. By integrating AI-enabled decision support, participatory engagement, and policy analytics, the proposed framework contributes to the advancement of secure and sustainable digital public health systems within future smart cities.