The Pacific Ocean contains approximately 25,000 islands, stretching from Papua New Guinea to EasterIsland, populated by mixtures of Melanesians, Micronesians and Polynesians, as well as migrant groups fromAsia and Europe. The region encompasses a third of the surface of the earth although it is sparsely populated ata total of around 9 million. With the exception of some of the more populated islands, such as New Zealand andHawaii, few surveys of chronic diseases have been conducted, but it is increasingly recognized that obesity,diabetes and associated conditions are emerging public health problems and clearly there is a need for cooperationto optimize control. Here we focus on cancer registry and epidemiological findings for Papua New Guinea, theSolomons, Vanuatu, Samoa, New Caledonia, Fiji, Polynesia, French Polynesia, Maori in New Zealand, NativeHawaiians, Micronesia, including Guam, and Aboriginal populations in Australia as assessed by PubMed searchesand perusal of the International Agency for Cancer Research descriptive epidemiology database. Overall, themajor cancers in males are oral and liver in Papua New Guinea and the Solomon Islands, and lung and prostateelsewhere (Fiji being exceptional in demonstrating a predominance of esophageal cancer), whereas in females itis breast and either cervix or lung, depending largely on whether cervical cancer screening program is active. Incertain locations thyroid cancer is also very prevalent in females. The similarities and variation point to advantagesfor collaborative research to provide the evidence-base for effective cancer control programs in the region.