DESCRIPTION (provided by applicant): The St. Louis-Cape Girardeau CCOP is a consortium of five hospitals serving parts of eastern Missouri and western Illinois. The mission of this organization is to provide access to clinical trials for community oncologists and their patients. St. John's Mercy Medical Center, the primary institution in the CCOP, is a tertiary care teaching hospital in St. Louis County. The other component hospitals are primarily located is smaller, rural communities with underserved patient populations. Providing access to state-of-the-art cancer treatment to these patients in their own community, and thus increasing involvement of these populations in clinical research, are important goals of the CCOP. One-thrid of all patients accrued to NCI treatment and preventiontrials are enrolled at CCOP sites. The program includes cancer treatment, prevention and control studies that benefit not only people with cancer but also people at high risk for cancer. It offers a variety of Phase II and III protocols including radiation therapy through RTOG, adjuvant treatment of breast and colorectal cancer through NSABP, and chemotherapy-based treatment of all major cancer types through SWOG. The repertoire of clinical trials is supplemented by using the CTSU menu as needed. Over the next five years approximately 80 patients per year will be enrolled in cancer treatment trials through the St. Louis-Cape Girardeau CCOP. SWOG, NSABP, and RTOG also offer cancer prevention and control studies which are a major focus of the CCOP. The St. Louis-Cape Girardeau CCOP was one of the top accruing sites for the STAR breast cancer prevention study and anticipates similar success with the upcoming STELLAR study. Approximately 60 cancer prevention and control credits are expected during each year of this grant period. By providing access to clinical trials in cancer treatment and prevention, the CCOP hopes to improve cancer care in the communities of western Illinois and eastern Missouri. When clinical trial participants are drawn from community hospitals and not just from universities, the study results are more applicable and relevant to the general population. The St. Louis-Cape Girardeau Community Clinical Oncology Program will do its part to achieve the NCI's goal to eliminate suffering and death due to cancer.