Cancer causes one in four premature deaths in OECD countries. It damages people’s quality of life, their ability to work, and their incomes. Cancer increases health expenditure and harms the economy through reduced labour force participation and productivity. The economic and social costs of cancer will grow as populations age and cancer treatment costs increase. This report demonstrates the strong economic and societal case for investing in cancer policies. Microsimulation modelling for 51 countries (including OECD, European Union and G20 countries), shows that stronger action on cancer would yield broad benefits. If all countries did as well as the best performing country in cancer care, a quarter of premature cancer deaths would be prevented. Addressing key cancer risk factors – including tobacco, harmful alcohol use, unhealthy diet, air pollution, overweight and physical inactivity – would lower cancer rates and health expenditure, while also increasing workforce productivity. Co-benefits of such policies include improving road safety and reducing greenhouse gas emissions. Vaccination for human papillomavirus will protect future generations from cervical cancer.