Background: São Tomé and Príncipe, a small island developing state, relies heavily on medical evacuations for specialised cancer care. This country does not yet have a population-based cancer registry. Therefore, limited data exist on cancer epidemiology in this population.

Objective: To characterise the profile of cancer among patients evacuated from São Tomé and Príncipe for medical treatment abroad.

Methods: Descriptive study of medical evacuation records from the Ministry of Health’s Patient Evacuation Board (2019–2025). Descriptive statistics were reported for patient demographics, year of evacuation, primary diagnosis, referring speciality, number of evacuations per patient and if travelled with an escort.

Results: Of 1,066 total evacuations, 413 (38.7%) were cancer-related. Cancer patients had a mean age of 48.3 ± 18.7 years with female predominance (58.6%). Breast cancer was most frequent (24.7%), followed by prostate (17.9%) and cervical cancer (9.4%). Most patients (76.9%) required single evacuation, with cancer patients more likely to have multiple evacuations.

Conclusion: Cancer represents a substantial burden among medical evacuees, with patterns suggesting opportunities for enhanced prevention and early detection programs. The high evacuation rate highlights critical gaps in local oncological capacity. Establishing a population-based cancer registry would enhance epidemiological data and inform public health strategies.