The 2014–2019 Cancer Plan, now entering its final year, is titled “Curing and Preventing Cancer: Ensuring Equal Opportunities for Everyone, Everywhere in France.” From the outset, it prioritizes coordinated action aimed at reducing all forms of inequality in the face of cancer. To assess the impact of preventive and curative measures implemented over the five years of this plan, in light of changes in risk factors and diagnostic or screening practices, our country has an observation system in which cancer registries serve as the gold standard. This report presents an analysis of trends in cancer incidence (new cases) and cancer mortality in metropolitan France between 1990 and 2018 (covering a period of nearly 30 years). It is the result of a partnership between the French cancer registry network Francim, the biostatistics and bioinformatics department of the Hospices Civils de Lyon (HCL), Santé publique France, and the National Cancer Institute (INCa). It is based on data collected from numerous sources, enabling the registries to achieve the comprehensiveness essential for estimating these indicators. This study serves as an updated reference to the most recent trends study published in 2013, which covered the period 1980–2012.