The truth often hurts, but only by knowing the truth can proper solutions be found. It has long been recognised that adequate epidemiological data is crucial for the planning and development of cancer programmes. In the First Report of the National Cancer Registry, 26,089 cases were registered among the population in Peninsular Malaysia. Taking into account the estimated 10,656 unregistered cases and the 3750 cases registered in Sabah and Sarawak, the total number of new cancer patients in Malaysia in 2002 would be approximately 40 500. This means that the cumulative lifetime risk of getting cancer was 1 in 4 in Malaysia, a fact which hit the headlines in many of the daily newspapers of the country. Cancer is indeed a serious national health problem. Correlating these registry findings with existing findings from studies on lifestyles, presentation of disease, diagnostic tests, interventions in cancer prevention, treatment, palliation and rehabilitation will be the way to go in defining and refining the strategy against cancer in this country.