An epidemiological assessment of the status and trends of cancer mortality shows that Europe is still divided by the rate of cancer death. Overall, cancer mortality in Europe has been steadily decreasing since the early 1990s. However, when the data are broken down, the burden of cancer in the central–eastern European countries is substantial, and mortality has actually continued to increase. Differences in lifestyle and environmental exposure are the most likely causes, and these are inevitably linked to political, social, and economic inequalities. For the time being, improvements in the health of the population are not a high priority for the new democratic governments. Even if attempts at cancer prevention are eventually realised, a major cancer burden will persist for many decades to come