Trends in cancer mortality in Switzerland over the period 1980-2001 and of incidence in the Swiss Canton of Vaud (640,000 inhabitants) over the period 1974-2003 are reviewed and discussed. Steady declines in cancer mortality were observed, over the last decade, particularly from the mid-1980's, with falls in overall mortality of 11% in men and 8% in women. The fall was of 20 % in male lung, whereas lung cancer has steadily increased in women by 47 %. Substantial declines were observed for stomach and colorectum in both sexes, (cervix) uteri and breast in women. Declines were also observed for leukaemias, Hodgkin's disease and testicular cancer, namely the neoplasms most influenced by therapeutic improvements, while trends in lymphomas and myeloma showed no clear pattern. With reference to incidence in the Vaud population between 1979 and 2003, all major tobacco-related neoplasms have declined by 19% in men aged 35 to 64, but increased by 69% in all age women. In both sexes, age-adjusted incidence of all non-tobacco-related cancers has substantially increased, mostly in younger-middle age (+ 70% in men, + 33% in women). Trends are discussed in the perspective of the European Commission's target of a 15% reduction in total cancer mortality between 2000 and 2015.