Causes of death

1. Key messages

2. Causes of death 

Tumours and cardiovascular diseases remain the main groups of causes of death

In 2022, tumours (neoplasms) and diseases of the circulatory system (or cardiovascular diseases) remained the main causes of death, accounting for almost half of all deaths (47% for both sexes). The proportion of deaths due to tumours and cardiovascular diseases has decreased slightly compared with 2021 (48% for both sexes).

Respiratory diseases and COVID-19 account for a higher proportion of deaths in men (17%) than in women (14%), while mental and neurological diseases are more prevalent in women (11%) than in men (8%). This latter difference is linked to the fact that women live on average longer than men, increasing their lifetime risk of developing dementia.

Increase in mortality from respiratory diseases and mental and neurological diseases in 2022

Since 2014 for men and 2020 for women, tumours have become the leading cause of death, overtaking cardiovascular diseases for the first time since the 1950s. This change is mainly due to a sharp drop in the age-adjusted mortality rate of cardiovascular diseases: 30% in men and 28% in women between 2012 and 2022. This decline reflects decades of progress in prevention and treatment. Notable contributing factors include the reduction in smoking, improved pharmacological treatments for hypertension and cholesterol, and medical procedures such as thrombolysis and stenting [1].

Overall, men have higher mortality rates, but they are declining faster than in women. From 2012 to 2022, tumour mortality fell by 21% in men and 11% in women. Deaths from respiratory diseases also dropped, by 23% in men and 9% in women.

However, deaths from mental and neurological disorders increased by 8% in both sexes. External causes (e.g. accidents and suicides) decreased in men (-8%) but rose slightly in women (+2%).

Between 2021 and 2022, mortality rates increased for all causes of death, except for tumours and external causes in men. The rise was particularly significant for respiratory diseases, with a sharper increase in women (+34%) than in men (+15%). Deaths related to mental and neurological disorders also went up (+10%). Finally, deaths from external causes increased in both men (+4%) and women (+8%).

The main specific causes of death differ according to sex and region

The ten leading causes of death in 2022 are ranked by age-adjusted mortality rates and presented by sex and for the general population.

• Men: ischemic heart diseases, COVID-19, and lung cancer.
• Women: dementia (including Alzheimer’s disease), cerebrovascular diseases (grouped with hypertension), and heart failure.
• General population: cerebrovascular diseases, dementia, and COVID-19.

Regional patterns are broadly similar, but some notable differences exist:

• Cerebrovascular diseases are the main cause of death for women in the Brussels Capital Region and in the Walloon Region, but ranks 3rd in the Flemish Region.
• Dementia (including Alzheimer’s) dominates in the Flemish Region for women, while ranking 2nd in the Brussels Capital Region and in the Walloon Region.
• COVID-19 remains prominent: 1st for men in the Flemish Region, 2nd in the Brussels Capital Region, and 3rd in the Walloon Region; for women, it ranks 3rd in the Brussels Capital Region, 4th in the Flemish Region, and 6th in the Walloon Region.
• Lung cancer consistently ranks in the top 4 causes of death among men and the top 5 among women across all regions.
• Heart failure shows strong regional variation, with higher rates in the Flemish Region. Since heart failure is often the final stage of other diseases, these differences may partly reflect coding practices.
• Breast cancer remains a significant cause of death among women, ranking 5th in the Brussels Capital Region, 6th in the Flemish Region, and 7th in the Walloon Region.

3. Read more

View the metadata for this indicator

Statbel: Causes of death

Sciensano: Standardized Procedure for Mortality Analysis (SPMA)

WHO: ICD-10

Background

The causes of death are classified according to the International Classification of Diseases 10th Revision (ICD-10) [2]. In this report, mortality is analyzed with the underlying cause of death as indicated on the death certificate. The underlying cause of death is by rule preferred to the immediate and the contributing causes of death for mortality statistics because, from a public health perspective, the objective is to break the chain of events leading to death and to prevent the precipitating cause [1].

In a first step, the causes of death are presented here according to the ICD-10 main chapters. Those are based on the first digit of the ICD-10 code. In a second step, the 10 most important specific causes of death are ranked by mortality rates for Belgium and by regions. 

To take into account the variations in the age structure of the Belgian population overtime and allow comparisons between periods, the rates are age-standardized (using the European standard population 2010 as reference).

For more details on the COVID-19 mortality between 2020 and 2022, consult the dedicated factsheet.

Definitions

International Classification of Diseases (ICD-10)

The International Classification of Diseases is an international codification for diseases and for a very wide variety of signs, symptoms, traumatic injuries, poisonings, social circumstances and external causes of injury or illness.

Underlying cause of death

The disease or injury which initiated the train of morbid events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury.

Immediate cause of death

The final disease, injury, or complication directly causing death.

Contributing cause of death

All other significant diseases, conditions, or injuries that contributed to death but which did not result in the underlying cause of death.

Tumours

Also known as neoplasms in ICD-10. The neoplasms group includes 95% of malignant neoplasms (or cancers), the other 5% being tumours of benign or borderline behaviour.

Age-standardized mortality rate

The age-standardization is a weighted average of age-specific mortality rates to remove variations arising from differences in age structure between population groups.

External causes
External causes refer to deaths resulting from unintentional injuries (accidents), homicide, suicide and other external factors such as medical misadventures, complications of medical or surgical care, or causes of undetermined intent.

References

1. Mensah GA, Wei GS, Sorlie PD, Fine LJ, Rosenberg Y, Kaufmann PG, et al. Decline in Cardiovascular Mortality: Possible Causes and Implications. Circ Res. 2017 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5268076/  
2. WHO. ICD-10: International statistical classification of diseases and related health problems: Instruction manual. Geneva: World Health Organization; 2011.

Please cite this page as: Sciensano. Mortality and Causes of Death: Causes of death, Health Status Report, 09 Sep 2025, Brussels, Belgium, https://www.healthybelgium.be/en/health-status/mortality-and-causes-of-death/general-mortality-by-cause