A detailed analysis of incidence and mortality rates for cancer of the pancreas for Ontario, Canada, over three to four decades shows that rates for men increased substantially to a peak in 1970-1974 and have fallen steadily since then. By contrast, rates for women, which also increased until the 1970s, have not subsequently fallen. These observations are consistent with a major role for cigarette smoking in accounting for the time trends, with smoking habits being particularly germane to risk in the subsequent decade in accord with results from a recent series of case-control studies. Rates from several European countries and Japan show patterns similar to those seen in the Ontario data, but the peak in rates for men has yet to be reached in some of these countries. These latter results are again generally consistent with an important role for cigarette smoking. There is no substantial evidence from comparisons of incidence and mortality rates for a recent improvement in survival, a finding in accord with current clinical observation.