HFH-MSU CSRN ACCrual Enrollment and Screening Site - Abstract This application is being submitted in response to the NOSI identified as NOT-CA-24-111. Metropolitan-Detroit based Henry Ford Health (HFH) has over 20 years of experience in the successful conduct of multi-site cancer screening and prevention clinical trials research. As an integrated health care delivery system, serving a racially and socioeconomically diverse catchment area, our cancer screening trials experience includes, electronic health record identification and engagement of at-risk populations, recruitment and long-term retention of research participants, and comprehensive follow-up of abnormal findings. This experience includes successful recruitment for the NCI Prostate, Lung, Colorectal, and Ovarian Cancer (PLCO) trial and National Lung Screening Trial (NLST). HFH enrolled nearly half (46%) of all participants in PLCO who were of Black race/ethnicity. More recently, HFH has successfully enrolled diverse patients in the GRAIL, Inc. sponsored studies – STRIVE and Pathfinder 2, a validation trial of the novel multi-cancer early detection test (MCD), Galleri®. HFH is also a data contributing site for the Population-based Research to Optimize the Screening Process (PROSPR) II, and two long term NIH-sponsored cohort studies, All of Us and Connect for Cancer Prevention. HFH includes seven hospitals, 41 ambulatory clinics, the Henry Ford Medical Group (HFMG) and Cancer Institute (HFCI), and the HFH-Michigan State University Health Sciences Center (HFH-MSU HSC). For over 50 years, HFMG physicians have provided care for the Community Health and Social Services (CHASS) Center, a Federally Qualified Health Clinic. The HFCI treats over 14,000 cancer patients annually. The HFH Department of Public Health Sciences, with over 250 faculty and staff, with significant experience in conducting externally funded clinical, epidemiological and health services research, will be the homebase for our multi- disciplinary team. HFH-MSU HSC also has world-class basic-science research programs developing new cancer screening technologies. We will leverage these existing resources to: 1) conduct a Vanguard pilot study to determine the most effective methods for recruiting and retaining diverse participants in MCD screening trials, 2) continually improve existing workflows for follow-up of participants with positive findings and establish long- term infrastructure for conducting high quality pragmatic cancer screening trials that are inclusive of socioeconomically disadvantaged or historically minoritized people and, 3) establish collaborative relationships with the Coordinating and Communications Center and Statistical and the Data Management Center that lead to impactful clinical trials which use the most promising new and emerging cancer screening technologies and utilize high-quality and efficient patient-centered data collection and management strategies. This supplement aims to augment subject recruitment and retention activities and facilitate study procedures that in conjunction with the National Cancer Institute, the study coordinating and statistical coordinating centers, and other recruitment hubs have been developed since from our original application.