Each year, low- and middle-income countries (LMICs) account for over 85% of the 400,000 newly diagnosed pediatric cancer cases. Survival rates in LMICs are 5-25% compared to 80% in high- income countries (HICs). Almost 1/3 of the survival difference can be attributed to treatment abandonment, defined as the failure to initiate or sustain treatment during four or more successive weeks, which is influenced by health system and individual level barriers. In Tanzania, prior research with caregivers of children with cancer and expert health care providers explored how misbeliefs and perceived community reaction and fears lead to delays in health seeking behavior and increased treatment abandonment. To target this internalized stigma and improve outcomes, tailored interventions are needed at the community level. However, the community perspective on stigma towards childhood cancer has not been evaluated, a critical knowledge gap. The current proposal will complete a comprehensive assessment to explore the unique stigmatization beliefs related to pediatric cancer and terminology used among the non-patient community population. This information will be used to inform the adaptation of a previously developed measure of cancer stigma, which can be used to monitor and evaluate the impact of community- based interventions targeting pediatric cancer stigma in LMICs. In 2014, the Duke Global Cancer Initiative was created, including a partnership between Duke University and Bugando Medical Centre in Mwanza Tanzania to improve the quality of global pediatric cancer care through research and clinical capacity development. This program is supported by the Duke Cancer Institute CCSG P30 grant (2P30CA014236-46) whose aims include the integration of all cancer-related research activities at Duke including global cancer capacity development. Previous P30 NCI supplement sponsored research successfully implemented interventions targeting both health system inefficiencies and individual barriers to care, including the development of a pediatric cancer clinical database, a patient navigation program, and establishment of a hostel program for patients and their families to stay during treatment. Although reduced, 32% of patients still abandon treatment. Of the known factors contributing to abandonment, we have yet to develop and intervention to address the community perception of childhood cancer. The support from this administrative supplement will allow us to complete our comprehensive evaluation of the impact of stigma on childhood cancer treatment abandonment, adding community-based data to our previously completed patient and provider level evaluations. This critical data will inform the development of targeted community-based stigma reduction intervention, continuing to drive the field of childhood global cancer forward and further reduce the immense global survival disparity.