ABSTRACT – Overall Cancer health disparities span the continuum of cancer care, including prevention, screening, early detection, diagnosis, interception, treatment and survivorship, and are driven by a complex interplay between social, psycho-social, lifestyle, environmental, structural, and biological determinants of health. This Duke Cancer Health Disparities (DCHD) P20 SPORE application evolved from institutional efforts to address this complex, multi-level problem, and represents the work of a group of basic, translational, clinical and population scientists working collaboratively and synergistically to address disparities at particular points in the cancer disparity continuum, while recognizing the complexities of the larger problem of achieving cancer health equity. Our OVERALL GOAL is to develop or improve new or existing interventions and therapies through a better understanding of cancer disparities prevalent in the Duke Cancer Institute’s catchment area. We propose the following Aims: provide the infrastructure, oversight, and resources to conduct innovative translational research to reduce cancer disparities through two projects focused on under-studied disparities (Aim 1); ensure availability of expert support through Administrative and Shared Resource Cores (Aim 2); seed Developmental Research Program (DRP) projects and grow the cancer disparities research community (Aim 3); and complete planning and transition activities in preparation of a P50 SPORE application, including participating in and leading inter- SPORE activities (with other P20s and with P50 SPOREs) that enhance our collective impact (Aim 4). We propose two Projects. Project 1 is entitled “Race-related RNA splicing in non-small cell lung cancer: functional interrogation and therapeutic targeting”. Project 2 is entitled “Racial differences in host immune response and gastric carcinogenesis: translating underlying biology to promote gastric cancer interception”. Our two P20 Projects will be supported by an Administrative Core, a Biospecimen/Pathology Core (Core 1), and a Biostatistics and Bioinformatics Core (Core 2). DRP projects funded by the P20 may graduate into full projects for the future P50 SPORE. The expected outcomes of these aims are to conduct groundbreaking research in cancer health disparities, to develop novel approaches to mitigate these disparities, and to prepare and submit a full DCHD P50 SPORE application for the continuation and expansion of these efforts.