ESGO

May 2026 · European Society of Gynaecological Oncology · Fondation Lalla Salma de Prévention et Traitement des Cancers

Status: V5 SHIPPED 2026-05-18

One agent. Two institutions. One continent of patients.

Axiom

A MOROCCAN-DIASPORA PATIENT — DARIJA AT HOME, FRENCH AT WORK, BI-RADS 4 ON THE PORTAL — IS HELD BY ZERO GOVERNED AI SURFACE TODAY. ESGO RUNS STATIC PATHWAYS IN ENGLISH. FOUNDATION LALLA SALMA RUNS RABAT-NATIVE ARABIC RESOURCES. NEITHER SPEAKS HER. AÏCHA 2.0 — CO-BRANDED ESGO + LSF + CANONIC, MULTILINGUAL CODE-SWITCHING NATIVE, GOVERNANCE-ATTESTED, EU AI ACT ART. 6 COMPLIANT FROM DAY ONE — IS THE EMPTY SPACE IN THE MIDDLE.

Format

1. Title

• title: CANONIC × ESGO × FONDATION LALLA SALMA — AÏCHA REFRAMED
• description: One co-branded, governance-attested gynaecologic-oncology agent. Maghreb-diaspora register native — Darija + Arabic + French + Spanish + English, code-switching first-class. Built by the two institutions whose patients she sits between.
• meta: CANONIC Foundation · 67 publications · 9 patent families · 20K+ governed patient interactions

2. The Patient — Aïcha

• eyebrow: WHO THE PARTNERSHIP IS FOR
• description: Aïcha is 49. Casablanca-born, Marseille-living. Hospital pharmacy technician at Hôpital Nord — Darija at home, French at work, English with her brother in Montréal. Her last screening mammogram came back BI-RADS 4. She has not yet told her mother, who survived breast cancer in Casablanca in 1998 without screening, without a Diagnosis Card in Darija, with a surgeon who spoke French to a husband who understood half of it. Aïcha inherited the genetic risk — and the institutional memory.
• the_cascade: Her journey is not one question, it is a chain. Every link wants a different society's guideline, and every link needs the same agent.
  • BI-RADS 4 TRIGGER | mammogram callback · core-needle biopsy scheduled at Hôpital Nord · she asks the agent what BI-RADS 4 means in Darija the night before | grounds in NCCN-breast + EUSOMA screening-and-recall guidance
  • BIOPSY + RESULT | invasive ductal carcinoma confirmed · early-stage · neoadjuvant decision pending | grounds in ESO-ESMO ABC + NCCN-breast treatment pathways
  • GENETIC-RISK DISCUSSION | mother's 1998 BC + Maghreb founder-effect prior (BRCA2 c.5946delT) → cascade testing → BRCA2+ result · sister and daughter now indicated for testing | grounds in NCCN Genetic/Familial High-Risk Assessment + ESMO BRCA clinical practice
  • GYN-ONC PREVENTIVE SURVEILLANCE | BRCA2+ opens the gynaecological surveillance and risk-reduction conversation she did not know she was about to have | grounds in ESGO Ovarian (risk-reducing salpingo-oophorectomy timing) + ESGO Cervical (HPV co-screening cadence) + ESGO Endometrial (post-menopausal symptom triage)
  • FERTILITY + LIFE STAGE | 49, perimenopausal, daughter is 22 and now a cascade-testing candidate herself · the fertility-sparing conversation is for the next generation, not Aïcha · she still needs to be the one to explain it | grounds in ESGO/ESHRE/ESGE Fertility-sparing consensus
• the_through_line: One patient. One agent. Five guideline domains. Two societies' corpora — ESGO for the gyn-onc spine, the breast-cancer society consortium (NCCN-breast · EUSOMA · ESO-ESMO ABC) for the trigger and the treatment. Every link in Aïcha's chain resolves to a published, hash-anchored passage her agent can cite back to her in the register she asked in.

3. The Empty Space — Three Apps. None Hold Her.

• eyebrow: WHY THE PARTNERSHIP MATTERS
• description: The morning of the biopsy, three surfaces fail her differently. They fail her even harder one week later when the genetic result lands and the question is no longer "what does BI-RADS 4 mean" but "what does BRCA2 mean for my ovaries, my cervix, my endometrium, my daughter." The empty space in the middle is what Aïcha 2.0 exists for.
• the_three_failures:
  • OLIVIA (ESGO patient pathway) | reads in French · does not answer questions asked in Darija · static info site, not conversational · gyn-onc only, silent on the breast trigger that opened the chain
  • FONDATION LALLA SALMA RESOURCE | classical Arabic · tells her what to do if she lives in Rabat · she lives in Marseille · cannot bridge breast-to-gyn-onc cascade
  • CHATGPT | serviceable code-switching Darija · cites nothing · auditable under no clinical regime · same hallucination surface whether the question is breast or gyn-onc
• the_truth: ESGO operates zero conversational AI agents today (Olivia / Cecilia / Emilia are static character-led info sites; the clinician Algorithms App is deterministic, not AI). LSF runs static resources. Neither operates a governed conversational layer in the patient's register. No surface in the market today carries a single patient across the breast-to-gyn-onc cascade — every existing app is single-society, single-disease, single-language. The market is open because the work is hard, and the work is hard because nobody has solved governance + multilingual code-switching + multi-society evidence chains in one surface.

4. The Bridge — February 2026

• eyebrow: WHY NOW
• description: Two convergence events in the same month. One visible bridge. No joint flagship yet named.
• the_convergence:
  • 6-7 FEB 2026 | Tangier | Fondation Lalla Salma convened its first "AI in Oncology" conference
  • 26-28 FEB 2026 | Copenhagen | ESGO inaugurated Prof. Jalid Sehouli — first Arab-Muslim ESGO President, family immigrated to Germany from Morocco
  • SUBSEQUENT | Marrakech | ESGO leadership convened strategic planning, deepening the Moroccan axis
• the_thesis: The institutional, geographic, and clinical signals are aligned for the first time. CANONIC delivers the substrate — and the multi-society corpus — that turns alignment into a flagship.

5. The Proposal — Aïcha 2.0

• eyebrow: THE ONE THING WE ARE PROPOSING
• description: One co-branded, governance-attested gynaecologic-oncology agent — with a multi-society corpus wide enough to carry Aïcha's entire cascade. ESGO owns the gyn-onc seal. The breast-cancer society consortium (NCCN-breast · EUSOMA · ESO-ESMO ABC) carries the trigger and the treatment. CANONIC federates the evidence and attests the governance. Maghreb-diaspora register native. Three seals on every interaction. Compliance from day one — not retrofit.
• the_seals:
  • ESGO ACCREDITED-CENTRE | clinical authority + guideline backbone for the gyn-onc spine (Cervical · Endometrial · Ovarian · Vulvar · Fertility-sparing)
  • FONDATION LALLA SALMA | regional reach + Houses of Life + Moroccan-patient trust
  • CANONIC GOVERNANCE ATTESTATION | evidence chain, hash provenance, ledger audit per interaction · federates ESGO + breast-cancer society consortium under a single attestation
• the_corpus_thesis: A real patient's chain crosses society boundaries. The corpus must too. ESGO is the authoritative seal on the gyn-onc half of Aïcha's chain; NCCN-breast + EUSOMA + ESO-ESMO ABC carry the breast half. CANONIC's role is to federate them into one cite-defensible surface — not to compete with either society's authority, but to compose them.
• the_compliance:
  • EU AI ACT ARTICLE 6 | high-risk medical AI · compliant from day one
  • EHDS | European Health Data Space · cross-border interop ready
  • GDPR + MOROCCAN LAW 09-08 | dual-anchored data protection · EU citizen + Maghrebi patient covered
  • MDR + NIS2 | medical device + network/info security secondary backbones

6. What CANONIC Will Deliver — Five Concrete Artefacts · Twelve Months

• eyebrow: THE WORK
• description: Five governed deliverables. The first lands in Madrid 2026; the last lands on stage at GITEX Africa 2027.

D1 — Aïcha 2.0 (Governed Multilingual Agent)

Darija + Arabic + French + Spanish + English code-switching, audit-defensible. ARABCHAT scope in CANONIC governance (currently state: PROPOSED, demo-stage). Evidence chain is foundational, not optional: every clinical claim Aïcha makes traces to a published society-guideline passage via SHA-256 doc-hash provenance. Two retrieval surfaces, one ledger: retrieve_esgo dispatches against the ESGO gyn-onc CAS substore (Cervical 2023, Endometrial 2025, Vulvar 2023, Fertility-sparing 2024, Ovarian + Arabic-translated pocket guideline, ENGAGe Diagnosis Cards — 14 of 14 LIVE Phase 1, full Algorithms App content Phase 2 under partnership grant); retrieve_breast dispatches against the breast-cancer society consortium substore (NCCN-breast, EUSOMA position papers, ESO-ESMO ABC consensus guidelines, NCCN Genetic/Familial High-Risk Assessment for the BRCA cascade — corpus extension declared in parallel under LONGFORM governance). Per-retrieval LEDGER entry, society of record stamped per passage. Aïcha's response footer carries the cite chain in the patient's language register, with the originating society named — ESGO for the gyn-onc surveillance answer, NCCN for the BRCA-cascade answer, ESO-ESMO ABC for the treatment-pathway answer.

D2 — Clinical-Validation Protocol

Joint prospective study across ESGO accredited-centres and Foundation Houses of Life. IRB-coordinated, multi-site, with Maghreb-diaspora-stratified enrollment. Validates Aïcha 2.0 against clinical-team benchmarks for clarity, faithfulness, and patient-experience metrics in each supported register.

D3 — Regulatory Attestation

EU AI Act Art. 6 · EHDS · GDPR · Moroccan Law 09-08 — signed per-interaction. Data-governance compliance is mechanically proven, not asserted: every Aïcha response carries the CAS hash chain + append-only LEDGER audit trail back to its source guideline passages. Article 6's "data governance" requirement becomes a green build gate, not a paper claim. Independent attestation memo accompanies each compliance regime.

D4 — Methods Paper

Three-way co-authorship — Sehouli + Foundation lead + CANONIC. Submission target: International Journal of Gynecological Cancer (ESGO's flagship). Demonstrates the overlay shape (governance + multilingual register + cite-chain provenance) as a reproducible methods contribution to gyn-onc AI.

D5 — Public Capstone

GITEX Africa 2027 Marrakech (April 2027). Aïcha goes live. Three seals on stage. Foundation Lalla Salma + ESGO + CANONIC presented jointly. Live demonstration in Darija + French to a Maghrebi audience.

7. The Team — Maghreb-Diaspora EU Axis

• eyebrow: WHO RUNS THIS
• description: The CANONIC EU axis is a Madrid-anchored team with Maghreb-diaspora clinicians, academics, and operators — matched to ESGO's clinician network, Sehouli's institutional reach, and LSF's regional anchor.
• principals:
  • DEXTER HADLEY, MD/PhD | CANONIC Co-Founder + Gov General | UCF/Stanford alumnus | Founding Chief of AI · 67 publications · 9 patent families
  • FATIMA BOUKRIM | CANONIC Co-Founder + Executive Director | Madrid + Orlando | Moroccan heritage · EU expansion lead · the introducer
  • MIFTA "SIMO" MOHAMED | Academic anchor candidate | Madrid + CMU SEI | XAI for healthcare · EU AI Act methods · long-time personal friend of Fatima
  • DR. JEAN CALLEJA | ObGyn clinical anchor | EU clinical-regulatory bridge
  • YOUNESS OUAHID + MAYSOUN DOUAS-MAADI | EU commercial track | Madrid | EC Expert Evaluator network
• evidence: Every team member's identity, credentials, and affiliation reads from a governed VITAE.md file in hadleylab-canonic/USERS/<NAME>/VITAE.md — no claim made in this deck is unbacked.

8. The Ask — One Step

• eyebrow: NEXT STEPS
• the_ask: Schedule a 45-minute three-way conversation. Foundation Lalla Salma leadership · ESGO Office of the President · CANONIC Foundation. Proposed within two weeks of receipt. Madrid 2026 hackathon planning closes early July.
• not_the_ask: We are not asking either institution to commit to Aïcha 2.0 in writing today. We are asking for one conversation to test the shape, the seals, and the timing.

9. Twelve-Month Arc

10. Close

• title: Aïcha. Reframed.
• urls:
  • canonic.org · contrelecancer.ma · esgo.org
• footer: CONFIDENTIAL · CANONIC × ESGO × FONDATION LALLA SALMA · MAY 2026

DECK | ESGO × LSF × CANONIC | V5 SHIPPED 2026-05-18 | AÏCHA REFRAMED