PROJECT SUMMARY - Cancer Control Research (CCR) Program The Cancer Control Research (CCR) Program of the USC Norris Comprehensive Cancer Center (NCCC) seeks to understand and modify cancer risk behaviors, improve cancer screening, and enhance cancer survivorship. CCR has two new co-leaders in this grant cycle: Jennifer Unger PhD, an expert on tobacco-related health disparities, cultural risk, and protective factors for cancer-related behaviors, and Myles Cockburn PhD, who develops, evaluates, and translates skin cancer prevention programs in the catchment area. Under their leadership, CCR has developed new intra- and inter-programmatic collaborations with a sharp focus on the new NCCC Strategic Plan priorities to develop multi-level models of cancer risk for precision prevention and to reduce cancer disparities and risk behaviors in our catchment area. The Specific Aims of CCR are: 1) To understand and modify cancer risk behaviors and improve cancer screening, with emphasis on cancer disparities and 2) To assess and improve cancer outcomes, with emphasis on cancer disparities. Indeed, the CCR's 33 members include national leaders in tobacco and vaping, obesity and physical activity, cancer screening, and adolescent and young adult (AYA) cancers, all with a focus on reducing cancer burdens and disparities in our catchment area of Los Angeles County (LAC). CCR members are PIs/MPIs on major collaborative grants that directly address catchment relevant cancer risk factors and behavior change, including: NCI U54 Tobacco Center for Regulatory Science (TCORS); NIH U01 to develop mHealth interventions; NIH P30 on environmental risks for obesity in Hispanics; and NIH U01 on health behavior adoption and maintenance. Transformative achievements in the current period include: (1) among the first to link e-cigarette use with initiation of combustible tobacco products in teens, and to document the impact of flavoring; CCR members testified to inform the newly signed bill in California (2020) banning sweet flavoring; 2) documenting the marketing of e-cigarettes to youth with claims of health benefits, leading to implementation of new policies to limit youth access to e-cigarettes use in Los Angeles County; 3) developing an efficacious skin cancer prevention intervention for underserved youth which has been adopted by schools in Southern California; 4) revealing significant financial toxicity and ethnic disparities in follow-up care among AYA cancer survivors; and 5) documenting under-utilization of breast cancer genetic testing that might otherwise improve treatment options for women. During the current grant period, CCR's 33 full members published 630 cancer-relevant articles (28% intra-program, 26% inter-program, 41% multi- institutional, 12% high impact). They hold $15.5M in cancer research funding (direct costs), with increases in overall (+39%), peer-reviewed (+34%) and NCI funding (+13%) since the 2015 CCSG review.