Alaska Native Tribal Health Consortium Comprehensive Cancer Program - Cancer is the leading cause of death among Alaska Native people; it accounts for one-fifth of all deaths. Alaska Native people experience statistically different cancer incidence and mortality rates from other U.S. populations, as well as from each other. The Alaska Native Tribal Health Consortium (ANTHC) is a tribal health organization formed in 1997 to provide health care services on behalf of the roughly 189,000 Alaska Native people in the state of Alaska. These services include, but are not limited to, specialty medical care and community health services, as well as construction of water, sanitation and health facilities. Cancers among Alaska Native people in Alaska have been tracked since 1974 by the Alaska Native Tumor Registry (ANTR), a National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) program located in the Alaska Native Epidemiology Center (ANEC) at ANTHC. The ANTHC NCCCP first applied for and received funds from the Centers for Disease Control and Prevention in 2005. This application is for the fourth five-year implementation grant. Program activities are implemented along the cancer care continuum: prevention, screening and early detection, diagnosis, treatment, survivorship, clinical care, and palliative care. Program efforts for the upcoming five-year period will specifically focus on prevention, screening and early detection, and survivorship. The Alaska Native people are an underserved population with an increased cancer risk due to significant health disparities in incidence, morbidity, and mortality. The objectives and strategies of this grant focus on addressing those disparities. In collaboration with internal and external partners, the NCCCP will utilize evidence-based interventions (EBIs) to institute policy, systems and environmental (PSE) change in tobacco, nutrition, physical activity, and obesity. Statewide and local community activities will contribute to an increase in colorectal, lung, breast, and cervical cancer screening. Survivorship activities will work to reduce morbidity and cancer recurrence and increase the survivor’s quality of life. Program activities will focus on addressing health disparities, through cultural responsive education, materials, and communications, provider training on adverse childhood experiences and trauma informed care, and community driven interventions. Surveillance and evaluation measures will provide the framework for program development and improvement. The main proposed outcomes of this project are as follows: • Increase in Alaska Native Elders and youth that meet the recommended physical activity guidelines. • Reduce rate of cancer incidence and recurrence. • Increase in number of Alaska Native youth that meet the physical activity guideline recommendations. • Increase public awareness about cancer prevention related to HPV vaccine. • Increase CRC screening rates. • Improve quality of life of Alaska Native cancer survivors.