Background <p>The Lao People’s Democratic Republic (Lao PDR) is experiencing an epidemiological transition with a rising burden of non-communicable diseases, including cancer. However, the absence of a national population-based cancer registry (PBCR) limits the understanding of the true cancer burden and its geographical distribution, hindering effective public health planning. We present the first spatial analysis of hospital-based cancer data in Lao PDR to address this critical knowledge gap.</p> Methods <p>We conducted a descriptive retrospective analysis of cancer cases recorded at the National Cancer Center from January 1, 2010, to December 31, 2024. Data on patient demographics, basis of diagnosis, and primary cancer site (ICD-10) were extracted and analyzed. Descriptive statistics were used to summarize patient characteristics, and spatial analysis was performed to map the geographic distribution of cancer cases at the district level across different time periods.</p> Results <p>A total of 1,738 cancer cases were analyzed, with a female/male ratio of 1.76 (1,108/630). The most frequent malignancy in males was liver and bile-duct cancer (15.1%), while cervical cancer was predominant in females, accounting for 41.1% of cases. Reported cases were heavily concentrated in Vientiane province and surrounding central provinces throughout the study period, suggesting under-reporting elsewhere. However, case detection in northern and southern provinces showed marked improvement in the most recent period (2020–2024), suggesting a strengthening of national surveillance capabilities. Cancer types varied in frequency across Laos, with cervical cancer cases being widely distributed.</p> Conclusion <p>This study reveals that Lao PDR faces a significant burden of cervical and liver cancers, with reported cases heavily concentrated in Vientiane. Despite recent surveillance improvements, the limitations mentioned above underscore the urgent need for a national PBCR for effective cancer control.</p>