This chapter seeks to learn more about emerging strategies for addressing racial and ethnic (R/E) cancer disparities and the lessons for program design that derive from implementation experiences. After describing the methods used in developing the case studies, it presents site characteristics, analyses of the causes of cancer care and outcome disparities and approaches to addressing them. Most programs perceived a disconnection between the target populations’ cultural perspectives on cancer and health services and health care practices. Many sites reported the R/E elders were unlikely because of past experiences of discrimination to challenge practitioners. Poverty, unemployment and associated problems constituted another barrier identified by many sites. Programs identified practitioner attitudes as another barrier to health service access and appropriate utilization. Several sites sought to reduce the risk of cancer by engaging elders and near-elders in programs to reduce specific risk factors or comprehensively promote health.