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In this paper, we present data from the Martinique Cancer Registry for the period 1981–2000 and interpret cancer incidence trends in the light of risk factor patterns. In Martinique, cancer data are available from 1981. The sources of information are represented by insurance records, medical evacuations, hospitals and laboratory files. We performed a Mantel–Haenszel χ2 test stratified on age in order to assess time trends and to compare incidence rates between men and women over the whole period. A total of 8992 incidents of cancer cases were recorded during the last 20 years among men and 6832 in women. (The overall age-standardized incidence rate is 222 per 105 person-years for men and 145 per 105 person-years for women.) The most common cancers are prostate cancer in men (104 per 105 person-years) and breast cancer in women (42 per 105 person-years). Except for thyroid and salivary gland cancer, men experienced higher incidence rates for all other cancers. Incidence of prostate cancer in men, breast cancer in women and colorectal cancer in both sexes strongly increased between 1981–1990 and 1991–2000, whereas no significant variation was observed for that of all digestive cancers together. Among women, cervical cancer incidence strongly decreased. These results demonstrate that Martinique tends to have the same cancer risk profile as France Mainland with, however, higher incidence rates for cervical, stomach and prostate cancer. Changes in lifestyle and greater accessibility to diagnostic and therapeutic procedures, in particular screening, have strongly contributed to the ‘epidemiological transition’ observed.