PROJECT SUMMARY Globally, there are more deaths from cancer than from HIV, tuberculosis, and malaria combined. In 2018, there were more than 18 million new cancer cases and 9.5 million cancer deaths worldwide, and, by 2030, these numbers will increase by at least 50%. Countries with low or medium Human Development Index account for more than 60% of cancer cases and 70% of cancer deaths. Cancer deaths in sub-Saharan Africa occur disproportionately from cancers that are preventable and/or curable including lymphoma, cervical cancer and breast cancer. Addressing the substantial burden of cancer requires a new generation of cancer researchers who can test hypotheses in the African context. The University of North Carolina Project- Malawi (UNCPM) has a rich cancer research environment that includes participation in the National Cancer Institute (NCI) U54 consortium for HIV associated malignancies, the AIDS Malignancy Consortium, the International Epidemiologic Databases to Evaluate AIDS (IeDEA), NCI African Esophageal Cancer Consortium, and a USAID-funded cervical cancer screening study. To date, UNCPM has had significant success in cancer clinical trials and translational research projects, and in establishing a handful of early- career investigators, but momentum is needed to build on this foundation. First, large improvements in cancer control in Malawi require approaches that extend beyond clinical trials to cancer outcomes research, a broader approach that requires unique skills. At this time, there are few cancer researchers with both the necessary cancer research skills and the local experience to develop cancer outcomes solutions adapted to the Malawian context. Second, there is no defined pipeline for early-career cancer research capacity. Finally, there are few opportunities for successful Malawian investigators to obtain the additional skills and experience necessary to be competitive for independent research funding. To address these gaps, we propose to establish the Malawi Cancer Outcomes Research Program (M-CORP). This application is led by UNC in conjunction with the University of Malawi College of Medicine (COM) and in collaboration with other national and international institutions and training programs. M-CORP aims to increase the cadre of trained investigators who can pursue independent research careers by: 1) establishing a robust curriculum and training opportunities across the continuum of cancer outcomes research specific to the Malawian environment and research priorities; 2) supporting advanced degrees; and 3) overcoming obstacles to research independence by providing post- doctoral opportunities including mentored pilot grants. We will use a multi-PD leadership strategy based at both UNC and UNCPM that will optimize our strengths across the spectrum of cancer outcomes research. An exceptional pool of multidisciplinary mentors, a detailed plan for program evaluation, and robust, broad-based partnerships between UNC and Malawia...