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Aims and Background: Although several studies have assessed cancer research performance in individual European countries, comparisons of European Union (EU27) performance with countries of similar population size are not available., Methods: We compared cancer research performance in 2000-2008 between EU27 and 11 countries with over 100 million inhabitants. Performance should not have been affected by the 2007-2009 recession. We examined 143 journals considered oncology journals by Journal Citation Reports, accessing them via Scopus. Publications were attributed to countries using a published counting procedure., Results: For number of publications, the USA held a clear lead in 2006-2008 (yearly averages: 10,293 USA vs 9,962 EU27), whereas the EU27 held the lead previously. EU27 was also second to the USA for total impact factor. China markedly improved its cancer publications record over the period. Compared to the USA, EU27 and Japan, the other countries (all developing) had a poor publications record., Conclusions: Comparative cancer research spending data are not available. However from 2002 to 2007, gross domestic expenditure on research and development (UNESCO data) increased by 34% in North America, 161% in China and only 28% in EU27. Thus the European Union is lagging behind North America and may well be eclipsed by China in research and development spending in the near future. We suggest that these new findings should be considered by policymakers in Europe and other countries when developing policies for cancer control.