Significant differences in mortality rates of the most of the death causes were detected between Moscow and Saint-Petersburg in the number of researches. Aim. Comparison and ranging of standardized mortality rates (SMR) from malignant neoplasms (MN) of different localizations in Moscow and in Saint-Petersburg in 2015 and 2018; determination of the localizations with main input in SMR from MN. Materials. Number of citizens and number of deaths from tumors accordingly to Rosstat Short nomenclature of the death reasons were evaluated. Death rates were calculated using the special computer programs on the base of European standard, comparison was provided with help of non-parametric criteria. Results. SMR of 29 from 33 MN localizations became lower in 2018 comparing to 2015 both in Moscow and in Saint-Petersburg. The average SMR decreased in 2018 in Saint-Petersburg statistically significant (p=0.003) and in Moscow non-significant (p=0.34). The largest SMR value both in 2015 and in 2018 in Moscow and in Saint-Petersburg as well were registered from 7 cancer localizations (trachea, bronchus, lungs; large intestine; breast; pancreas; rectum; prostate). The share of these SMR localizations in all MN was 57% and 54% in Moscow and 57 and 56% in Saint-Petersburg correspondingly. SMR of all 7 localizations were lower in Moscow comparing to Saint-Petersburg. SMR was lower in 2018 comparing to 2015 in both cities. The share of MN of others, unspecified, non-classified, etc. localizations in all MN was 11% in 2015 in both cities. Its share was in 2018 13.5% in Moscow and 10.1% in Saint Petersburg. Conclusions. SMR of most MN was higher in Saint Petersburg as in Moscow both in 2015 and in 2018. The analyses of the effectiveness of screening programs and of health care organization for patients with MN with highest SMR is needed. The questions of the differential diagnostics (intravital and postmortem) and of control the quality of medical death certificates filling in should be solved for the decrease of mortality of “nonrefinement” MN. © 2020 Consilium Medikum. All rights reserved.