I am the study pathologist in a large (~800 cases) population-based study of colon cancer in 33-counties of North Carolina examining traditional dietary and lifestyle risk factors, access and utilization of health services; and polymorphisms of carcinogen metabolizing enzymes. As a companion study, we are enrolling some of these subjects in a national colorectal cancer family registry that will have the potential to identify genetic markers for colon cancer risk. A major objective of this study is to determine why African-Americans with colon cancer fare more poorly than Caucasian Americans. A follow-up proposal dealing with the same issues for rectal cancer was funded and has recently begun.