The Montana Cancer Consortium (MCC) is an independent, nonprofit organization whose mission is to bring state-of-the-art cancer care to Montana, Idaho, and Wyoming through National Cancer Institute (NCI) sponsored clinical research. MCC coordinates, supports and improves the activities of physicians and other cancer care professionals, cancer centers and hospitals across the service area to maximize patient access to the highest levels of cancer care with a focus on access to clinical trials. In addition, MCC helps to design and influence cancer care delivery research through continued participation that informs and speeds validated care innovations into clinical practice. The region has been characterized as `mega-rural' with limited access to care due to the vastness of the geography, lack of university-based treatment and research facilities, and lack of primary care providers. Montana, Idaho and Wyoming are home to seven, five, and one American Indian Reservations respectively, where issues of poverty, distance, and cultural taboos surrounding cancer care discussion and treatment create unique disparities to prevention, early diagnosis, treatment and survivorship of cancer. The overall goal of MCC is to increase access to clinical trials in the service area while improving the delivery of cancer care through research. This is accomplished through inclusiveness of membership, communication, education, a commitment to quality, and participation in national clinical trial initiatives. The MCC NCORP Community Site consists of 10 primary affiliate sites and nine sub-affiliates that collectively serve nearly two million residents in an area covering over 200,000 square miles. Membership includes 60 oncology investigators representing all cancer care specialty areas. MCC is a member in good standing with the four adult research bases, and is poised to provide and support expanded access to state-of-the-art cancer treatment, control, prevention, screening, surveillance and care delivery through NCI-sponsored clinical trials. Strong leadership, an involved network of member physicians and dedicated affiliate sites strengthens MCC as an NCORP Community Site.