To determine the relation between serum selenium (Se) values and the development of cancer, we compared serum Se levels among cancer patients, non-cancer patients, and healthy adults. Serum Se values in cancer patients were examined with respect to primary cancer sites separately. We tracked non-cancer patients and healthy people for 5 years after serum collection to examine whether low Se status is a risk factor for cancer. The mean serum Se values in cancer patients were significantly lower than in non-cancer patients. This difference, however, failed to exist in women 50 years of age and less. In the examination of serum Se values with respect to organs with primary cancer, mean serum Se values for 6 organs were significantly lower than those in non-cancer patients and healthy people. However, female breast cancer patients showed a higher value. During the 5 year follow up, patients who developed cancer had lower values than that in subject who remained non-cancer and sex differences were absent. We were unable to rule out low Se status as a possible risk factor for cancer, a result supported by our 5-year follow-up. In distribution of non-cancer patients classified by serum Se values, the proportion of patients with low serum Se values (80 ppb or less) was relatively high (12%). If low Se status increases the risk of cancer, low Se status as a risk factor for cancer should be considered even in Japan, where Se intake is sufficient.