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Background: An efficient registration system with accurate and timely information on cancer incidence and mortality is key to development of policies to prevent and control cancer. A traditional registration system usually needs 3-4 years to collect data and publish a cancer report. However, researchers, policymakers and healthcare professionals need to know the latest cancer registration data quickly. Methods: A computer system has been operating with cases reported online by hospitals and followed up in communities at the Cancer Registry of Guangzhou (CRG) since 2008. The comparability, completeness, accuracy and timeliness of collected data were here evaluated. Results: From 2010 to 2014, 181,194 cancer cases from 1,916,253 medical records of cancer were reported to the CRG online. 53,473 cases were deleted as duplicates (47,906), wrong diagnoses (410) or residents of other places (5,157) during the follow up. Successful final follow-up rates were over 90% for both newly and previously diagnosed cases by general practitioners in community clinics. The CRG coding and classification system follows international standards. The annual trends for all sites by sex were stable from 2010 to 2014. All age-specific incidence rates for childhood cancers were within the limits of the respective international references. The overall M:I ratio for all sites but C44 was 56.7%.,ratios for most sites in Guangzhou being between Hong Kong and Shanghai. A total of 75.7% of the cancer cases reported in 2010–2012 were morphologically verified. Ninety five percent of new cases completed registration within 29.0 months in 2010, reducing to 8.0 months in 2014. Conclusion: The online report system with community follow up at the CRG yields reasonably accurate and close-to-complete data. It takes less time to confirm diagnosis and other information so that reporting annual incidence one year after the close of registration becomes possible., (Creative Commons Attribution License)