A cancer needs assessment, funded by the National Cancer Institute, was conducted in Pohnpei State (Pohnpei), Federated States of Micronesia (FSM). Findings revealed that cancer is the third leading cause of death in Pohnpei, yet cancer-related awareness, prevention, detection, and treatment services are limited. A number of needs were identified, and an action plan was developed based on five priority areas: 1) increasing community awareness about cancer (especially, cervix, breast, liver and lung) and related risk factors; 2) securing funding for cancer prevention and control planning and activities; 3) establishing a fully staffed cancer prevention and control office; 4) building local capacity for cancer cytology; and 5) increasing capacity to obtain and process lab specimens for high-risk patients.