This study provides an updated analysis of trends in cancer incidence and mortality in metropolitan France over the period 1990–2018. National incidence estimates are based on modeling of observed incidence data (new cases) through 2015 from cancer registries, supplemented by projections through 2018. Mortality data (deaths) are from the Center for Epidemiology of Medical Causes of Death. Twenty-seven cancer sites, corresponding to solid tumors, were studied, including analyses for 22 subtypes (classified by anatomical location or histology) and age-specific trends, made possible by the new methodology adopted. Approximately 382,000 new cases of cancer (204,600 in men and 177,400 in women) and 157,400 cancer deaths (89,600 in men and 67,800 in women) occurred in metropolitan France in 2018. Between 1990 and 2018, the incidence rate remained relatively stable among men and continued to rise among women, while mortality rates declined in both sexes, more markedly among men. The incidence rate of several cancers is increasing in both sexes: skin melanoma, pancreatic, liver, kidney, and thyroid cancers are among the most common sites. The situation is concerning among women, where the incidence rates of lung and breast cancer continue to rise. At the same time, colorectal cancer and cancers linked to alcohol and tobacco (lip, mouth, and pharynx; larynx; esophagus) show no downward trend. Among men, the stability in lung cancer incidence masks an increase in adenocarcinomas and a decrease in squamous cell carcinomas. On the other hand, encouraging signs are observed among men, with the recent decrease in incidence and mortality for two of the three most common cancers (prostate and colorectal) and for several cancers linked to alcohol and tobacco.