A total of 4981 cancers were recorded in Kingston and St Andrew during the period 2003 – 2007: 2536 in males and 2445 in females. Age standardized rates per 100 000 per year (ASR) were 188.8 and 144.2 for males and females respectively, and are relatively unchanged, compared to the previous report (188.6 for males and 144.2 for females, 1998 – 2002). In males, the leading sites for cancer were prostate, bronchus and large bowel, while in females, they were breast, cervix uteri and large bowel. The leading sites for both genders have been maintained in the same order as in the previous report, but for males, there were increases in the incidence of prostate (ASR 65.5 vs 78.1 per 100 000 per year) and colorectal (ASR 13.7 vs 17.2 per 100 000 per year) cancers and a decrease in the incidence of cancer of the bronchus (ASR 22.8 vs 18.6 per 100 000 per year). For females, there was a modest decrease in incidence of cervical cancer (ASR 19 vs 17.4 per 100 000 per year) while the incidence of cancers of the breast and large bowel remained relatively stable (ASR 40.1 vs 43 per 100 000 per year for breast and ASR 13 vs 12.8 per 100 000 per year for colorectal cancer). These data support the need for urgent institution of formal programmes for prevention and control of cancers of the breast and large bowel in the Jamaican population. Malignancies of unknown primary site were common in both genders and require further investigation.