SUMMARY /ABSTRACT Access to relevant biospecimens is critical to translational research on minority populations. The lack of research specimens from racial and ethnic minority populations in the U.S. remains a barrier to understanding racial/ethnic differences in cancer development, progression, and outcomes. In particular, the paucity of clinical biospecimens from understudied populations, including Native Hawaiians, other Pacific Islanders, and Asian Americans has limited the ability to address critical disparities in cancer risk and outcomes affecting these U.S. communities. Hawaiʻi, the most ethnically diverse state in the nation, has experienced a higher burden of common cancers-- including liver, breast, lung, colorectum, endometrium, and stomach, compared to the U.S overall. Moreover, wide racial and ethnic disparities are observed within Hawaiʻi's uniquely diverse multiethnic population including Native Hawaiians who have the highest mortality for breast, liver, lung, and other common malignancies. The value of the biospecimens collected at the University of Hawaiʻi Cancer Center (UHCC) is evident in the breadth and scope of its translational research. Despite this progress, biorepository efforts at the UHCC to date have been fragmented and limited for certain types of specimens, especially fresh frozen tumor tissue. Current UHCC biospecimen resources include a statewide repository of clinically-annotated, de-identified archival formalin-fixed paraffin-embedded (FFPE) tumor tissue and prospectively and retrospectively collected blood, urine, oral rinses, and stool from consented individuals. In contrast, the collection of fresh frozen tissue has been largely limited to small scale collections for disparate investigator-initiated studies. There is a crucial need at UHCC to standardize and centralize the collection of fresh frozen tumor and blood from cancer patients in our participating community hospitals and to integrate these collections with existing resources in order to optimize their utility for cancer research. We propose to develop a Pathology and Biospecimen Core that will integrate and augment existing and new biospecimen resources with respect to their acquisition, processing, tracking, storage, and distribution and will support Project 1 (NASH/liver cancer), Project 2 (lung cancer), Project 3 (breast cancer), Career Enhancement Program (CEP) and Developmental Research Program (DRP) projects, as well as other UHCC investigations with the goal of developing a robust infrastructure to address differences in cancer risk and outcomes in Asian American, Native Hawaiian, and Pacific Islander (AANHPI) ethnic minority populations. Aim 1 will focus on the development of a repository of paired fresh frozen tumor tissue and blood specimens from multiethnic cancer cases diagnosed in the state of Hawaiʻi with cancers of the lung, liver, breast, colorectum, endometrium, pancreas, and stomach. Potential cases will be identified via rapid rep...