This present study was conducted with the objective of providing the cancer profile of Larkana, the fourthlargest city of Sindh, Province. The study included two sets of patients. The first set included the incident cancercases, residents of Larkana, who reached Karachi for diagnosis or treatment. The second set consisted of the incidentcancer cases registered at the Aga Khan University (AKU) Pathology collection points at Larkana during 1st January2000 to 31st December 2002. The age-standardized rates (ASR) for cancer (all sites) were 134.2/100,000 in males and110.3/100,000 in females. The most common malignancies in males were lymphoma, oral cavity, prostate, liver, andurinary bladder. Cancers in females were breast, oral cavity, lymphoma, skin and thyroid. Tobacco-associated cancersaccounted for approximately 35.0% of the tumors in males and 18.6% in females. The gender ratio was 1.5, themean age of cancer all sites was 45.5 years (95% CI 34.6; 56.4) in males and 42.9 years (95% CI 33.6; 52.2) infemales. This is the first attempt to determine the cancer incidence pattern of Larkana and should serve as a guidelinefor estimation of the cancer burden of Pakistan and the cancer control program of the country. The data must beinterpreted with care, as they are largely pathology-based with approximately 15-30% population-wise underregistration.However, the chances of selective collection bias were minimized as the AKU pathology specimens werecollected from 2 centers within the city, Each collection centre provided diagnostic service to several health centresgiving wide population coverage, thus ensuring adequate sampling from the entire city.