Pilot Project 2: Project Summary Ovarian cancer is a highly fatal disease with a five-year relative survival of less than 50%. However, ovarian cancer survival is not the same for all women. Asian American ovarian cancer patients have the highest survival across all major racial groups, however the Asian American population is heterogeneous. Studies have shown that analyzing Asian Americans as a single group overlooks important ethnic-specific disparities, and this has been observed for ovarian cancer. Hence, this pilot project aims to better understand these disparities using data from the California Cancer Registry (CCR). The CCR is an ideal data source for this project given that it includes detailed demographic, socioeconomic, tumor, and treatment information by Asian subethnic group and covers the geographic region in the United States that is home to the largest number of Asian Americans. Our preliminary analyses of Asian American ovarian cancer patients using data in the CCR showed ethnic- specific percent differences for several survival-related characteristics. To clarify these differences, Aim 1 of this project will examine the association between Asian subethnic group and ovarian cancer tumor characteristics. Certain Asian subethnic groups may be more likely to present with ovarian cancers of a particular grade, stage, or histology, hence the ethnic-specific survival disparities may be attributed to the tumors themselves. Aim 2 of this project will examine whether receipt of National Comprehensive Cancer Network (NCCN) guideline adherent care and its association with ovarian cancer survival differ across Asian subethnic groups. NCCN guideline consensus statements reflect the most current and accepted standard for cancer treatment, hence the ethnic- specific survival disparities may be attributed to the treatment and care received. Certain Asian subethnic groups may be more likely to receive NCCN adherent care and receipt of that care may be differentially associated with survival. Given the fatality of ovarian cancer, understanding why some women die from ovarian cancer while others do not is a public health priority. Few ovarian cancer studies have focused on Asian Americans, hence this pilot project will not only shed light on an understudied segment of the population, but will do so in a way that recognizes the importance of the population’s heterogeneity so ethnic-specific disparities are not overlooked. Understanding how ovarian tumors and treatment care may differ by Asian subethnic group will inform the future work that is needed to understand the underlying factors contributing to ovarian cancer disparities and survival overall.