On Jul. 16, 1983, the National Cancer Institute launched the Community Clinical Oncology Program (CCOP) to provide a mechanism for community physicians at large to be involved in cancer clinical trials, to bring the benefits of clinical research to patients in their own communities. The CCOP initiative is designed to bring the advantages of clinical research to cancer patients in their own communities.

NCORP is committed to integrating health disparities research questions across all studies in the network. By bringing cancer clinical research studies to individuals in their own communities, the NCORP research reflects the national population so the evidence generated contributes to improved patient outcomes and a reduction in cancer disparities for all people.

Research questions in this area address disparities in clinical trial outcomes and cancer care delivery related to the most serious, prevalent cancers and cancer-related problems which disproportionately affect different populations. It includes studies to: enhance participation in clinical trials; address determinants of disparities; and evaluate differential outcomes in different populations.

Although academic medical centers play a crucial role in cancer clinical research, the majority of cancer care takes place in the community setting. Expanding clinical research beyond the academic environment allows access to a larger and more varied patient population treated in a variety of healthcare delivery settings, which can accelerate accrual to cancer clinical trials and other human subjects research and increase the generalizability and relevance of study findings. Research in community settings reflects the complexity of cancer care delivery and engages community oncologists in research to develop care delivery approaches that can be implemented within usual clinical workflow.

The foundation of NCORP is the conduct of multi-site cancer clinical trials and other human subjects research in the primary focus areas of cancer control, prevention and care delivery. NCORP plays an important role in the National Clinical Trials Network (NCTN), a major NCI-supported infrastructure for cancer clinical trials. Approximately 30% – 35% of the patients enrolled on NCTN clinical trials, including precision medicine studies, are from NCORP sites.

The NCORP Sites have responded to many of the challenges associated with implementation of precision medicine by providing quality specimens for genomic sequencing and establishing a multidisciplinary team to support the newer generations of clinical research. Recent advances in technology are providing new opportunities to characterize premalignancies in ways that will enhance the development of cancer prevention interventions, and biomarkers of response to those interventions, and biomarkers of risk.

The NCORP network’s diversity in patient age, race/ethnicity, and geographic location as well as partnerships with non-oncology practices provides a natural laboratory for the development of strategies for precision prevention to improve efficiency of trial implementation and to balance the risks and benefits of interventions. At the same time, the role of the immune response is increasingly incorporated in cancer prevention research. Cancer screening research to reduce aggressive cancer incidence and to identify overdiagnosis is needed to reduce overall cancer mortality, both in therapy and for prevention. Community organizations have proven to be well positioned to advance the science of symptom management, cancer prevention, and surveillance, and to improve the enrollment of participants of various backgrounds in clinical research.