The SCCC-Upstate is a merger of two successful legacy CCOPs known as Southeast Cancer Control Consortium, Inc. (SCCC) and Upstate Carolina (hereafter the Consortium) comprised of 23 components and 63 sub-components, located in a five-state area of the Southeast US (GA, NC, SC, TN, and VA) with a nonclinical Administrative Office (AO) in Winston-Salem, NC. The Consortium eliminates a critical barrier by supplying service to the rural southeastern area. The AO provides expertise, regulatory support, training, education, and principal investigators to enable small rural community hospitals, private practices, and solo practitioners the ability to provide clinical trials to ther patients. With this structure, rural centers will be able to translate academic-generated concepts to the real world. Economic constraints prohibit most hospitals and private practices from allocating the required resources to conduct research independently. This structure has been successful in supporting rural communities for the past 30 years. This was the vision of Charles L Spurr, MD that has been carried on by Drs. Atkins and Bearden to make clinical trials available in the patient's home community. Each component has a responsible investigator and coordinator to organize and promote clinical research participation. Over 232 investigators and 140 research staff located at 86 treatment centers are involved in the delivery of research in a variety of community settings. The vast geographical area improves the opportunity to increase access of NCI-sponsored clinical trials. The long-term objectives are to: 1) provide cutting edge clinical trials; 2) implement programs to enhance cancer care delivery; 3) build on existing relationships and establish new collaborations; and 4) actively enroll participants to clinical trials. The catchment area of the components is over 9.5 million, with diverse demographics including a significant African American population. NCI support of this grant will allow restricted federal dollars to be maximized over a vast rural geographic area reaching rural and medically underserved populations.