Between November 1998 and December 1999, trained medical record abstractors visited the Micronesian jurisdictions of Chuuk, Kosrae, Pohnpei, and Yap (the four states of the Federated States of Micronesia), as well as the Republic of Palau (Belau), the Republic of Kiribati, the Republic of the Marshall Islands (RMI), and the Republic of Nauru to review all available medical records in order to describe the epidemiology of cancer in Micronesia. Annualized age-adjusted, site-specific cancer period prevalence rates for individual jurisdictions were calculated. Site-specific cancer occurrence in Micronesia follows a pattern characteristic of developing nations. At the same time, cancers associated with developed countries are also impacting these populations. Recommended are jurisdiction-specific plans that outline the steps and resources needed to establish or improve local cancer registries; expand cancer awareness and screening activities; and improve diagnostic and treatment capacity.