This study compares cancer profiles, trends, and determinants in China and the United States in 2022. In 2022, China is expected to have approximately 4.82 million new cancer cases and 3.21 million cancer deaths, while the USA is expected to have 2.37 million new cancer cases and 640,000 cancer deaths. The most common cancers in China are lung and colorectal cancer, while in the USA, they are breast and lung cancer. Lung cancer is the leading cause of cancer death in both countries. In the USA, age-standardized incidence and mortality rates for lung and colorectal cancer have decreased, but liver cancer rates have slightly increased. In China, rates of stomach, liver, and esophageal cancer have decreased, while rates of colorectal cancer, prostate cancer, and seven other cancer types in women have increased. Population aging and adult population size are major determinants of incremental cancer deaths, while case-fatality rates contribute to reduced cancer deaths in both countries. The cancer profiles of China and the USA are converging, with decreasing burdens in liver, stomach, and esophagus cancers and increasing burdens in lung, colorectal, breast, and prostate cancers. Population aging is a growing determinant of cancer burden. Progress in cancer prevention and care in the USA, along with measures to address population aging, may help China reduce its cancer burden. The study highlights the need for effective cancer prevention strategies, including early detection and screening, and the importance of addressing modifiable risk factors such as smoking. The findings suggest that China may benefit from adopting some of the effective prevention measures from the USA, as well as actions to support healthy aging.This study compares cancer profiles, trends, and determinants in China and the United States in 2022. In 2022, China is expected to have approximately 4.82 million new cancer cases and 3.21 million cancer deaths, while the USA is expected to have 2.37 million new cancer cases and 640,000 cancer deaths. The most common cancers in China are lung and colorectal cancer, while in the USA, they are breast and lung cancer. Lung cancer is the leading cause of cancer death in both countries. In the USA, age-standardized incidence and mortality rates for lung and colorectal cancer have decreased, but liver cancer rates have slightly increased. In China, rates of stomach, liver, and esophageal cancer have decreased, while rates of colorectal cancer, prostate cancer, and seven other cancer types in women have increased. Population aging and adult population size are major determinants of incremental cancer deaths, while case-fatality rates contribute to reduced cancer deaths in both countries. The cancer profiles of China and the USA are converging, with decreasing burdens in liver, stomach, and esophagus cancers and increasing burdens in lung, colorectal, breast, and prostate cancers. Population aging is a growing determinant of cancer burden. Progress in cancer prevention and care in the USA, along with measures to address population aging, may help China reduce its cancer burden. The study highlights the need for effective cancer prevention strategies, including early detection and screening, and the importance of addressing modifiable risk factors such as smoking. The findings suggest that China may benefit from adopting some of the effective prevention measures from the USA, as well as actions to support healthy aging.