The Duluth CCOP, established and funded by the National Cancer Institute (NCI) in 1984, with successful competitive grant renewal in 1987, 1990, 1995, 2000, and 2005 is the only program of its kind in northern Minnesota and northwest Wisconsin and it is one of two CCOPs in Minnesota. The Duluth CCOP is comprised of physicians and ancillary support staff who practice under the umbrella of the St. Mary's Duluth Clinic Health System (SMDC) in three institutions in Duluth, MN: the St. Mary's Duluth Clinic Cancer Center (SMDCCC) St. Mary's Medical Center (SMMC) and SMDC Medical Center (formerly known as Miller Dwan Medical Center). Hematology/Oncology clinics are also served by SMDCCC hematologists/oncologists at various regional outreach sites throughout the SMDC catchment/service area. Geographically, the Duluth CCOP covers a large area including urban and rural areas, with a radius of over 150 miles from Duluth. The Duluth CCOP brings the benefits of clinical research to patients in a region that would be without access to clinical trials due to the distance from the nearest comprehensive cancer center. The strategy of the Duluth CCOP is to provide patients in the region access to state-of-the-art cancer care through participation in NCI supported treatment and cancer control protocols. The North Central Cancer Treatment Group will continue to function as the primary research base of the CCOP and secondary research bases will be the Eastern Cooperative Oncology Group, and the National Surgical Breast and Bowel Project. The Duluth CCOP will also continue to open trials through the Clinical Trial Support Unit of the NCI. Children have access to Children's Oncology Group studies via an affiliation between SMDCCC pediatric hematologists/oncologists and the University of Minnesota Masonic Cancer Center. The goal of the Duluth CCOP is to accrue annually 150 patient credits to treatment protocols and 220 patient credits to prevention/cancer control protocols. A robust culture of cancer care that supports multi-disciplinary treatments allows us to deliver the best possible therapy while maintaining a high level of accrual to clinical trials.