Background:The role of local health departments (LHDs) in addressing cancer prevention and control (CPC) is not well defined. Only general information about LHD services is described in the periodic national survey of LHDs conducted by the National Association of City and County Health Officials (NACCHO). The objective of this analysis is to describe the role and function of North Carolina (NC) LHDs in CPC.Methods:A survey of medical directors of NC LHDs (n= 85) was conducted between September and December 2018, to understand both the services provided by the LHD and medical director and the necessary training to provide those services. Nonrespondents received several reminders by email, and two phone call attempts were made to the health departments with no response to email reminders. The response rate was 70.6%. Results:Preventive counseling around tobacco cessation, nutrition, and physical activity is provided by 77.6%, 94.8%, and 82.8% of LHDs respectively, with 27.6%, 19.0%, 24.1% of LHDs having these services provided by medical directors directly either exclusively or along with other staff. Cancer screening is provided by 98.3% of LHDs. Mostcommonly is cervical cancer screening (98.3%), and other cancer screening (93.3%). In 51.7% of LHDs, screening is provided by medical directors directly.Conclusions:Cancer prevention activities are fairly common among NC LHDs, and cancer screening is almost universal. Comparing data from this survey of NC LHDs to the 2016 national NACCHO survey, rates of cancer screening may be higher in NC. Nationwide, 32% of LHD’s perform cancer screening; while our survey reports 98.2% do so. The NACCHO survey does not include comparable questions on cancer prevention services.