OBJECTIVES: The Japanese Cancer Control Act took effect in 2007. The objectives of the Cancer Control Act are to improve regional cancer care and promote a uniformly high level of cancer care nationwide. To achieve these goals, the Act specifies that all 47 prefectural governments in Japan formulate cancer control programs (CCPs) by 2008. Our study aimed to systematically review the CCPs of 45 of Japan’s prefectural governments that were formulated by January 2009 and then compare them to the programs that have been established in the West. METHODS: Six areas of the CCPs of 45 of Japan’s prefectural governments were systematically reviewed: “prevention,” “treatment,” and “palliative care.”etc. Parameters assessed included whether the proportion of smokers was being investigated, whether the numbers of radiation therapy and chemotherapy specialists engaged in cancer therapy were known, and whether the number of palliative care beds was known (a total of 224 parameters). RESULTS: The highest-rated plan overall received a score of 65.8, and the lowest a score of 35.3. Of the 45 plans, 21 (47%) established target values without actually determining the current proportion of minors who smoke, 25 (56%) did not investigate the numbers of specialists in cancer therapy. In addition, areas in which Japan is similar to the UK and the US, which operate CCPs on a national level, were clarified. CONCLUSIONS: It was found that not a few of the programs rest on shaky foundations and are of questionable implementability. An international comparison revealed that Britain’s NHS Cancer Plan has achieved a reduction in the smoking rate and increased anticancer drug use, and the United States’ NCCCP has produced results by supporting the CCPs of virtually all 50 states, achievements that should serve as a model for Japan.