NW Tribal Comprehensive Cancer Project - The Northwest Portland Area Indian Health Board (NPAIHB) is a Tribal organization governed by the 43 federally recognized tribes of Idaho, Oregon, and Washington, and represents 401,000 American Indian/Alaska Native (AI/AN) people. Our Tribal elders and health care planners clearly recognize the immense impact that cancer has in our tribes, and they have looked to the NPAIHB’s Northwest Tribal Comprehensive Cancer Project (NTCCP) for leadership in cancer prevention in Tribal communities. With CDC funding, our project has provided critical services for our constituent tribes for twenty-two years. As the first Tribal cancer control project in the CDC Comprehensive Cancer Control Project, we continue to set a high standard in delivering culturally appropriate services rooted within an Indigenous framework and governed by Tribal voice. The NTCCP will continue to implement evidence-based interventions (EBIs) that align with the three priority areas of primary prevention, early detection and screening and the health and wellbeing of cancer survivors. Through the proposed EBIs, and centering the 20-year Tribal Comprehensive Cancer Control Plan, we seek to decrease cancer incidence and mortality, improve screening, increase community cancer education, reduce the time from appearance of symptoms and signs to diagnosis, improve treatment compliance, and lengthen cancer survivorship for Tribal members in our region. The anticipated outcomes by the end of this project period are as follows: Increase percent of AI/AN youth ages 13 - 17 who have completed the HPV vaccination series from 67.5% to 70.5% by June 2023. Decrease AI/AN youth commercial tobacco use from 29.2% to 26.2% by June 2023. Decrease percent of AI/AN adult smoking prevalence from 25% to 22% by June 2023. Increase the percent of AI/AN women age 50 years and older who have had a mammography screening within the past two years from 22.8% to 25.8% by June 2023. Increase the percent of AI/AN women age 24 – 64 who have had a cervical cancer screening test within the past two years from 27.4% to 30.4% by June 2023. Increase the percent of AI/AN adults aged 45 – 75 years who are up to date on a USPSTF recommended colorectal screening test from 24.4% to 27.4% by June 2023. Increase the number of telehealth ECHO/trainings on cancer survivorship for health professionals from 3 to 5 by June 2023. We have established multiple partnerships with Tribal, state, and federal programs in addition to cancer centers, universities, and private foundations concerned with cancer prevention among Tribal peoples. We will continue to nurture and maintain our longstanding partnerships with cancer registries to increase program capacity and support cancer control planning. The Tribal cancer coalition will continue to meet with tribal and comprehensive cancer partners to address cancer prevention and control, build partnerships, share data, cancer resources, identify and address common priorities, and develop strategies to eliminate cancer health disparities. While we have made substantial contributions to Tribal cancer prevention and control in NW Tribes, there are still challenges ahead. We are optimistic that working closely with our Tribal coalition members, our partners, and our CDC colleagues, we will impact the reduction of cancer incidence and mortality. We strive for improvement in cancer survivorship and quality of life toward the next seven generations of healthier, cancer-free Tribal communities.