Europe is facing a cancer epidemic, with rapidly increasing incidence rates. Population growth and ageing will further increase the annual number of new patients with cancer. Cancer is a huge and growing contributor to the burden of disease and premature death within the European Union (EU). One in four of all deaths in the EU is attributable to cancer, and in the age range 45-64 years, the figure is almost one in two deaths. The 27 EU Member States differ greatly in cancer incidence, mortality and survival. Yet at least one-third of the cancer burden is preventable and a further third can be detected early and treated effectively, even on the basis of existing knowledge. "Cancer", however, comprises an extremely complex group of diseases and achieving the full potential for prevention and treatment poses very significant challenges. Success in cancer control will depend on a co-ordinated approach that involves every aspect of policy and service delivery. The objective of this paper is to outline the basic requirements of an integrated strategy for cancer control, emphasising the co-ordination of the key elements of primary prevention, secondary prevention (screening), integrated care and advances in research, all at national and EU level. It is based on a detailed review of the status of cancer control in the EU today and summarises the policy recommendations arising from this review, undertaken under the auspices of the Slovenian Presidency of the European Union in 2008.