Objective  To analyze the distribution and changing trend in malignant tumor mortality and rank order of death causes among female residents in urban and rural China from 2004 to 2015.

  Methods  We extracted the data on mortalities due to malignant tumors during 2004 – 2015 from national disease surveillance system and analyzed the data statistically. Chi-square test was adopted to analyze yearly and regional differences in malignant tumor mortalities.

  Results  Malignant tumor mortality was the second or third leading cause of deaths among female residents in China during the period. The top five of malignant tumor deaths were lung, stomach, liver, esophagus, and colorectal and anal cancer. Lung cancer showed the most obvious upward trend, rising from 1 747/100 000 in 2006 to 2 769/100 000 in 2015. The malignant tumors with higher mortalities in urban than in rural female residents are lung, colorectal and anal, and breast cancer (all P < 0.001); the malignant tumors causing more deaths in rural than in urban female residents are stomach, liver, and esophagus cancer (P < 0.001 for all).

  Conclusion  Among female residents in China during 2004 – 2015, malignant tumor mortality was the second or third leading causes of death; the mortality of lung cancer increased markedly; the top five malignant tumors were lung, stomach, liver, esophagus, and colorectal and anal cancer; there were urban-rural differences in rank order of deaths due to malignant tumors.