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Background. Cancer is a major problem and monitoring of its incidence is important. Aim: To estimate cancer incidence in western Libya. Methods: Data were collected retrospectively from Tripoli Medical Center during 2008. Classification of cancer diagnosis was made according to the International Classification of Disease. Results: A total of 1051 cancer cases were found (50.1% males and 49.9% females). Age-wise, 31% were younger than 15 years, 64.6% between 15 and 64 years and 4.2% above 64 years old. In females, most common cancers were breast (23.7%), colorectal (9.4%) and uterine (8.6%). In males, they were lung (15.6%), colorectal (12.3%) and prostate (9.9%). In females there were two peaks (in age group 40-44 and in those older than 75). Conclusions: Cancer incidence in western Libya increases with age. Most common cancer in men was lung cancer and in women was breast cancer. Further larger studies are needed to confirm such findings. Public health education, including antismoking and tobacco control, as well as awareness campaigns regarding early detection of cancer are needed to reduce cancer mortality.