Background: We have investigated cancer patient satisfaction with care and the extent to which it varies between and within hospitals. Design and methods: A national survey of cancer patients in England with questions in 10 different dimensions for four common cancers: breast, colorectal, lung and prostate (55,674 patients). We compared hospitals across tumour types, and against the national average. Results: Dissatisfaction was greater (p < 0.001) in younger, female patients. Breast cancer patients expressed least, and prostate cancer patients expressed greatest dissatisfaction. Breast, colorectal and prostate cancers showed significant (p < 0.001) pair-wise correlations for standardised satisfaction scores, particularly for in-hospital care. Summed hospital satisfaction scores showed significant associations across different dimensions of care. Conclusions: Cancer patient satisfaction is measurably different between hospitals, as well as by tumour type. For many aspects of care there is evidence of systemic hospital-level factors that influence satisfaction as well as factors common to the care pathways experienced by individual patients. Factors amenable to clinical or managerial intervention deserve further investigation.