OBJECTIVES: The incidence of cancer is on rise in Malaysia. Despite the existence of different screening methods the response to screening is poor.  The current study aims to examine cancer patients’ perceptions towards cancer screening and early diagnosis. METHODS: A qualitative methodology was used to collect in-depth information from consented cancer patients, recruited from February to July 2010. After obtaining institutional ethical approval, patients with different types and stages of cancer from the three major ethnic groups (Malay, Chinese and Indian) were approached. Twenty semi-structured interviews were conducted.  All interviews were audio taped, transcribed verbatim and translated into English for thematic content analysis. RESULTS: Thematic content analysis yielded four major themes: Awareness on cancer screening, perceived benefits of cancer screening, perceived barriers to cancer screening and cues to action. Majority of the respondents had never heard of cancer screening before the diagnosis. Some accounted of heeding mammogram and pap-smear tests but did not undergo screening due to a lack of personal susceptibility.  Those who have had negative results of screening prior to diagnosis perceived such tests as untrustworthy. Lack of knowledge and financial constrains were reported as barriers to cancer screening. Finally, numerous suggestions were given to improve screening behaviour among healthy individuals, including role of mass media in disseminating the message ‘prevention is better than cure’. CONCLUSIONS: Patients’ narratives revealed some significant issues that were in line with the health belief model which could explain   negative health behaviour. The description of the personal experiences with the cancer could provide many cues to action for those who have never encountered this potentially deadly disease if incorporated into health promotion activities.