OBJECTIVE To describe the secular trend of cancer incidence in Catalonia and to compare it with that observed in European regions. MATERIAL AND METHOD Using data from the Tarragona and Gerona cancer registries, the number of cases, adjusted rates, and the annual percentages of change in cancer incidence in Catalonia for the period 1985-2002 were estimated. Cancer incidence trends in Catalonia, Spain, and four European regions were compared using variations in the adjusted rates between the periods 1993-1997 and 1998-2002. RESULTS The number of invasive cancers increased from 15,773 in 1985 to 30,755 in 2002. The adjusted incidence rate showed an annual increase of 2.64% in males and of 1.81% in females. Almost all tumoral types showed an increasing trend. The most frequent malignant tumors in males were prostate, lung, colon and rectum, and urinary bladder tumors, showing increases of 8.74%, 1.67%, 3.47% and 4.32% respectively. The most frequent tumors in females were breast, colon and rectum and corpus uterine tumors, showing increases of 2.45%, 1.67% and 0.78%, respectively. In males, Catalonia showed lower annual incidence rates than the remaining European regions in 1985 and higher rates in 2002. In females, rates remained lower than in other European regions. CONCLUSIONS In Catalonia, the number of incident cancers increased because of population growth and aging, greater exposure to risk factors and, for some cancer types, higher detection rates. Overall cancer incidence trends followed a similar pattern to those of southern Europe, with higher increases than in the remaining European regions, especially in males.