Cancer of almost every type is more common in old age; over 10% of nursing home (NH) residents have cancer.We have conducted a cross-sectional study of cancer patients newly admitted to NH. We used the SAGE database that includes information on the residents of 1492 NH in 5 US states (1992 - 1995). Data collected with the Minimum Data Set were cross-linked to Medicare inpatients claims. Of the 145,757 patients, 21,064 over 65 years of age were diagnosed with cancer. The most common cancers were prostate (11%), lung (9%), colon (7%), and breast (5%). In women, the prevalence of cancer decreased with age, while it increased slightly among men. More than half of residents was at least 75 years; residents with prostate and colon cancer were oldest. While nearly 90% of residents experienced moderate-tosevere ADL limitation, most had no or minimal cognitive impairment. Daily complaints of pain varied between 23% (colon) to 39% (lung) of patients. Among patients with pain, over 20% received no analgesics. Women with breast cancer were the least likely to have pain untreated (19%) and those with colon cancer the most likely (26%). Nearly 35% of residents in pain received morphine except in the case of colon cancer (20%). Overall the prevalence of chemotherapy and radiation was infrequent. Upon admission to NH, less than 25% had an explicit terminal diagnosis. Yet, the 1-year mortality rate was high; for each form of cancer, the median survival time was 47 days. This study testifies that cancer is increasingly prevalent in NH, a sector not readily prepared to provide appropriate care.