The Montana Cancer Consortium (MCC) consists of two components (the central data management office in Billings and one component from Great Falls) with eight affiliates [Missoula (2), Helena (1), Kalispell (2), Butte (1), Bozeman (1) and Great Falls (1).] MCC is composed of 44 physicians, which includes all medical and radiation oncologists within the state. The Consortium encompasses a catchment area which includes the entire state of Montana with extension into Wyoming, Idaho, and the Dakotas (some 150,000 sq. miles/population of 903,000). This area is uniquely rural, as well as home to Native Americans from eight reservations. Objective l: Accrual. MCC has named the Southwest Oncology Group (SWOG), the National Surgical Breast and Bowel Project (NSABP), and the Radiation Therapy Oncology Group (RTOG) as primary research bases. MCC estimates a 5% increase per year in accrual to treatment clinical trials. Cancer control accrual for the SELECT trial is estimated at 50 participants per year; and the STAR trial has an estimate of 20 new participants per year. Objective 2: Quality. MCC has centralized data management for this large geographic area to one office in Billings. Centralization facilitates registrations and data management. A quality assurance program has been implemented to facilitate registrations and submission of quality data in a timely manner. The consortium has consolidated into two Institutional Review Boards and two pharmacies. Objective 3: Access. The cooperative effort of the MCC with hospital and health care providers from Montana and surrounding states improves access to state-of-the-art cancer treatment and prevention for an extensive, largely rural population. The network of MCC physicians provides a higher profile for clinical trials, which will create a stimulus to increased accrual. By promoting protocol participation in this geographically unique area and its inclusion of the minority component, MCC provides an excellent site for diffusion of knowledge and improved cancer care in a consortium, which is essential to achieve the NCI's CCOP intent.