PROJECT SUMMARY/ABSTRACT: Vanderbilt-Ingram Cancer Center SPORE in Gastrointestinal Cancer (P50CA236733) This application is being submitted in response to the Notice of Special Interest (NOSI) identified as NOT- CA-23-038. The Vanderbilt-Ingram Cancer Center SPORE in Gastrointestinal Cancer focuses on colorectal cancer. This project for the Administrative Supplement for NCI Global Oncology Mentored Research will assess the pattern of molecular characteristics for colorectal cancer and assess feasibility for molecular testing for CRC through a formal mentored research relationship between researchers at Vanderbilt University Medical Center and a mentee (a colorectal surgeon) at Kilimanjaro Christian Medical Center (KCMC), Tanzania. Dr. Ayesiga Herman is an early-career low-middle income country researchers (ESLIs) who is actively involved in the care of colorectal cancer patients in Northern Tanzania. He has observed an increasing proportion of patients with early onset CRC in Tanzania, and the molecular features of these tumors are not known. We think the knowledge to these features in will play a role on management and surveillance for CRC. We therefore propose a study to look at the distribution of molecular features for CRC patients and assess their association with social demographic and clinical factors. Also we will assess the feasibility for a prospective registry for these molecular features at KCMC. We will retrospectively review records and analyze the molecular features for colon and rectal cancer samples banked in KCMC pathology laboratory for the past 5 years. Also a prospective registry will be established for the new CRC patients and assess the feasibility for molecular testing at KCMC. Funds from this subcontract will be used for molecular features analysis, support the salaries for ESLIs, a research assistant, and a laptop for the research assistant. Dr. Alexander Hawkins (colorectal surgeon), Martha J. Shrubsole, (colorectal cancer epidemiologist) and Robert J. Coffey, MD, (Researcher) comprise the research mentoring team at Vanderbilt. Prof Blandina Mmbaga will be the local mentor for Dr. Herman and she will meet monthly to assess the progress of the project. As primary mentor, Dr. Hawkins will be responsible for career development and research project mentoring for Dr. Herman. In that role, he will meet weekly via zoom to discuss the progress of the project, will travel once to KCMC, Tanzania for training during the year, and will the ESLIs for training at Vanderbilt once during the year.