Knowledge of the cancer profile is an important step in planning rational cancer control programs and evaluation of their impact. Due to rapid changes in cancer incidence in China, national surveys may be insufficiently timely to provide adequate descriptions of the national burden. To evaluate the utility of cancer registries in describing the national cancer profile, this study compared two methods of estimating national cancer-specific incidence and mortality in China 2005, based on the Third National Death Survey (method I) as compared with registry material (method II). A total of 2.6 million cancer cases and 1.8 million cancer deaths were estimated by method I, as compared to 2.8 million cancer cases and 1.9 million cancer deaths using method II. The higher level of burden using the latter method in part may be due to a sizable differential in the magnitude of incidence rates across registries for certain cancer sites. Most cancer registries have been located in relatively more developed urban areas, or rural areas associated with higher risk for certain cancers. There are substantial differences in the cancer profile between urban and rural communities in China, and there may be concerns regarding the national representativeness of the data aggregated from this set of cancer registries. Timely and reliable estimation of cancer can only be realized if accurate information is available from cancer registries covering representative samples of the country.