This paper presents projections for cancer mortality, incidence and burden of disease (as disability adjusted life years) for 2005, 2015 and 2030. The projections are based on the latest available WHO mortality estimates from 2002, updated with mortality data from 107 countries and augmented by region and site-specific cancer survival models. Cancer accounted for an estimated 7.6 million deaths in 2005, and 72% of these deaths were in low-income and middle-income countries. For cancer deaths under age 70, 79% are estimated to occur in low-income and middle-income countries. Without intervention, the number of global deaths is projected to rise to 9 million in 2015 and a further 11.5 million in 2030. The rising burden of this disease, especially in low-income and middle-income countries, leads us to propose a global goal for cancer: a 2% reduction per annumover and above that which may happen as a result of current trends in prevention, case management and treatment. Achieving this goal would result in 7.7 million fewer deaths from cancer over the period from 2005 to 2015. More of these deaths will be averted in low-income and middle-income countries than in high-income countries. The scientific knowledge to achieve this goal already exists, and the target could be reached through effective cancer prevention strategies, including tobacco control, hepatitis B vaccination and prevention of cervical cancer.