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Compared to Isaac:
Cain is a bit faster (easier to dodge), has more luck (given by the Lucky Foot item, this stats affects rewards when completing a room amongst other things), and starts with a key (second treasure room is therefore almost guaranteed). If you have Afterbirth, you can unlock the Paper Clip as a starting trinket for him, ensuring free golden chests.
His lower health (2 red hearts instead of 3) and shorter range are irrelevant once you know how to play properly (dodging monster attacks and knowing the hitboxes).
So, yeah, overall Cain is a better Isaac, unless you consider the D6 as a "must have" item (which isn't, to be honest, you'll realise it when you reroll a bad item into a worse one 5 times in a row). His downsides aren't relevant once you know how to play, so it's all good.
i forget what, but he's not been very great for a LONG time.
cain is mostly lazarus with less health for my money, i'm fairly inconsistent with him, there's just nothing i can't easily have with every other character to offer me.