Background: This Research program will examine the reasons for disparities in health care delivery, and develop and test interventions to reduce disparities in health care. It is our belief that many of the disparities in cancer outcomes are due to poor and middle class minority patients receiving less than optimal care. The Cancer Center for Excellence at Grady is the perfect environment to study healthcare disparities and to establish new standards for providing quality care to the traditionally underserved. A great body of literature has been developed over the past several years demonstrating that Black-White disparities in cancer outcome (increased mortality and shorter overall survival among Blacks) are due to disparities in care. Clinical trial results in a number of cancers demonstrate that equal treatment yields equal outcome, yet studies of health practices show that there is not equal treatment. For example, a chart review of care given to patients in the medical oncology clinic at GMH shows that nearly a third of women undergoing adjuvant chemotherapy do not complete their prescribed course of chemotherapy. The six Full Projects listed have all been awarded their own funding to date; these monies will not be supplemented with money from this Grant, despite the fact that these investigators have agreed to support the Administrative Core. However, the P.I.s on all the Full studies have agreed to serve as mentors and assets for younger, predominantly minority investigators, with research ideas which we may then fund through the Pilot mechanism.