OBJECTIVES: Since the 1970s, cancer incidence and mortality have been increasing rapidly in China. The purpose of this study was to project cancer incidence of the fourteen major cancers in China from 2010 to 2030 by evaluating the potential effects of the population growth, change in age structure, and urbanization. METHODS: A demographic approach was taken for projection. Cancer incidence rates, projected populations, and urbanization rates were obtained or derived based on the database from the Chinese cancer registry office, the U.S. census bureau, and the Department of Economic and Social Affairs of the United Nations, respectively. Incidence rates and population data were categorized by area (rural vs urban), gender (male vs female), and age (5-year age groups). Cancer incidence was projected by applying the area-, gender-, and age-specific incidence rates of each cancer to the corresponding subpopulations in 2010, and 2030 respectively. The fourteen tumor types included cancers of the bladder, breast, cervix, colorectum, esophagus, head and neck, kidney, liver, lung, melanoma, ovary, pancreas, prostate, and stomach. RESULTS: Compared with 2010, the incidence of the fourteen major cancers in China will increase by 64.3% in 2030 from 2.6 million to 4.3 million. The urban incidence population and the senior incidence population (>=65 years old) will be more than doubled (from 1.1 to 2.5 million, and 1.2 to 2.5 million respectively). The top five cancers (lung, stomach, liver, esophagus, and colorectum) accounted for more than 77.5% of the fourteen major cancers in 2010, and they will increase by 55.8% from 2.2 million to 3.5 million in 2030. Cancers of the prostate, bladder, colorectum, pancreas, and lung are among the fastest growing cancers. CONCLUSIONS: The aging population and the accelerated urbanization trend in China will drastically increase cancer incidence in the near future, and this will impose a significant economic burden on the health care system.