The Madras Metropolitan Tumour Registry (MMTR) was established at the Cancer Institute (WIA), Madras, in 1981-1982. Cancer is not a notifiable disease in India, and hence registration per force has to be active. The MMTR covers a population of 3.8 million. Mortality statistics are obtained from the Department of Vital Statistics, death registers in hospitals and by active follow-up of registered cases. A total of 28,980 (13,012 males, 15,968 females) cases were registered during 1982-1991. The average annual world-standardised age-adjusted rates (AAR) per 100,000 are 104.2 in males and 129.0 in females. The lifetime cumulative risk (0-74 years) of cancer in Madras is one in eight. Stomach (AAR:15.2) is the leading site of malignancy among males, followed by cancers of the lung (AAR:9.8) and oral cavity (AAR:9.4). Among females, cancer of the cervix (AAR:44.0) is the commonest, followed by breast (AAR:21.7) and oral cavity cancers (AAR:9.8).