Trends in death certification rates from all cancers and seven selected cancer sites (bone sarcoma, soft-tissue sarcoma, ovary, testis, non-Hodgkin's lymphomas, Hodgkin's disease, leukaemias) were analysed for the population aged 15-24 years in Europe and, for comparative purposes, in the United States of America (USA) and Japan over the period of 1965-1998. Overall, there was a decrease in total cancer mortality of approximately 40% for both sexes. The declined mortality is largely attributable to better treatments and inclusion in multicentre clinical trials. The degree of improvement was similar in Japan and the USA, but was less in Eastern European countries, reflecting delays in the application of effective treatments, and limited involvement in large, well-designed clinical trials for these curable cancers in Eastern Europe. [authors]