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Background: Access to COG clinical trials has led to significant improvements in overall survival rates; hoever, disparities persist, particularly among Black and Hispanic patients, AYAs, and the inadequately insured. Bhatia, PBC, 2011 In 2008, to improve access to this largely underserved population, to COG institutions University of Illinois at Chicago UIC and Rush University and a non-member hospital John H Stroger Hospital formerly Cook County Hospital created a unified COG program utilizing one lead IRB and one research team. This study assesses the impact that the UICRushStroger COG program had on minority and AYA clinical trial enrollment. Methods: Comparative analyses of COG enrollment data from 2002-2008 and 2008-2014 pre vs. post-merger including enrollments by raceethnicity, age at diagnosis, gender, insurance status, clinical trial type biology, registry, therapeutic, epidemiology , diagnosis, and outcome as completed.Results: Enrollments onto COG clinical trials increased by 248 percent 2002-08: n = 160, 2008-14: n = 556 . Of the post-merger enrollments, 68 percent ere minority non-hite patients and 50 percent ere AYAs ages 15-39 , a 16 percent increase in representation for both populations. There as a 96 percent increase in enrollments for uninsured patients and 71 enrollments occurred at Stroger, a non-member site prior to the merger. Enrollments increased for all diagnoses by at least 100 percent and the maximum increases ere seen in diagnoses that carry a orse prognosis in children and AYAs [Brain tumors by 15x, AML by 30x, Non-Hodgkin Lymphoma by 20x]. SEER, 1975-2004 Although follo-up time as shorter for post-merger patients, overall survival improved by 50 percent. Conclusions: Significant increases in COG protocol enrollments, especially for under-represented minorities and AYAs, ere a direct result of the creation of this tri-institutional COG research program. Improving access to clinical trials is essential to addressing current disparities in cancer and the UICRushStroger COG Program serves as a model to increase enrollment opportunities for minority and AYA patients.,J Clin Oncol 34, 2016 suppl; abstr e18000 ,Publication Only Health Services Research and Quality of Care