Causes of death

Neoplasms have become the first cause of death in Belgium in 2019

Population
Neoplasms have become the first cause of death in Belgium in 2019

Statbel, the Belgian statistical office, publishes today the causes of death for 2019.

In 2019, neoplasms[1] (malignant, benign or of uncertain behaviour) were, with 25.5% of cases, the first cause of death in Belgium, ahead of diseases of the circulatory system (25.1%). Diseases of the respiratory system are the 3rd cause of death (11.2%).

However, there are regional disparities. While the Flemish Region follows the national ranking, the same is not true of the other two regions. In the Brussels-Capital Region, the first two places are the same, but the third place goes to the large group of ‘other natural deaths’ (including, among others, diseases of the blood, of the eye, of the ear, of the musculoskeletal system, of the skin, cases related to pregnancy and those not elsewhere classified). In Wallonia, the situation is unchanged compared to 2018: diseases of the circulatory system still rank first ahead of neoplasms and diseases of the respiratory system.

Men follow the national ranking in a more evident way: the main cause of death is due to a neoplasm in 28.6% of cases and to a disease of the circulatory system in 23.4% of cases. Among women, the order is reversed. The main cause of death is attributed to a disease of the circulatory system (26.7%); neoplasms are the second cause (22.6%). We observe the same trends by gender in the three regions of the country.

Significant changes in the initial causes of death

While the relative share of certain diseases as an initial cause of death is becoming increasingly marked - such as ‘other natural deaths’ or, to a lesser extent, mental and behavioural disorders[2] - that of diseases of the circulatory system has been declining for several years. They accounted for 36.3% of deaths in 2000 compared to 25.1% in 2019.

Deaths due to neoplasms show a decreasing trend, especially among men

Following the World Health Organization (WHO), both benign and malignant neoplasms are grouped together in one category of cause of death, which we will refer to below as neoplasms (ICD-10; Chapter 2; codes C00-D48: Neoplasms).

In 2019, the highest proportion of deaths was due to neoplasms (27,739 established deaths, or 25.5%), in contrast to previous years where most deaths were due to cardiovascular diseases (in 2019: 27,297 deaths, or 25.1%).

In order to make a meaningful comparison with previous years, the mortality ratio is shown below as the number of deaths per 100,000 inhabitants. If we look at the number of deaths per 100,000 inhabitants due to neoplasms over time, we see that it remains relatively stable, but that a slight decrease has started in recent years. It remains to be seen whether this trend will continue in the coming years.

When the figures are broken down by gender, we see that this decrease is particularly noticeable in the male population; in contrast, we see a slight increase in the female population compared to 2018. The difference in deaths between both genders per 100,000 inhabitants therefore shows a decreasing trend. However, men still die more often as a result of a neoplasm than women.

Year Total Men Women Difference
Number Number/100,000 Number Number/100,000 Number Number/100,000
2000 26,197 255.9 15,004 299.7 11,193 213.9 85.8
2001 26,313 256.4 15,026 299.4 11,287 215.2 84.3
2002 26,799 259.9 15,264 302.7 11,535 219.0 83.7
2003 26,705 257.9 15,136 298.7 11,569 218.7 80.0
2004 26,165 251.7 14,819 291.3 11,346 213.7 77.6
2005 26,635 255.0 15,239 298.1 11,396 213.6 84.5
2006 26,533 252.4 14,996 291.5 11,537 214.9 76.6
2007 26,707 252.3 14,927 288.1 11,780 218.0 70.1
2008 27,615 258.9 15,551 297.7 12,064 221.7 76.1
2009 27,525 256.0 15,371 291.7 12,154 221.6 70.1
2010 28,302 261.1 15,846 298.3 12,456 225.3 73.0
2011 28,346 258.8 15,705 292.4 12,641 226.5 65.9
2012 28,402 257.4 15,910 293.9 12,492 222.2 71.7
2013 28,717 258.7 16,002 293.8 12,715 225.0 68.8
2014 28,519 255.8 15,801 288.6 12,718 224.1 64.6
2015 28,598 255.1 15,857 288.0 12,741 223.4 64.7
2016 28,560 253.5 15,915 287.4 12,645 220.7 66.7
2017 28,275 249.7 15,510 278.6 12,765 221.8 56.7
2018 27,724 243.7 15,290 273.1 12,434 215.2 57.9
2019 27,739 242.7 15,191 269.9 12,548 216.2 53.7
Table 1: Number of deaths due to neoplasms, by gender (2000-2019)

Figure 1: deaths due to neoplasms per 100,000 inhabitants, by gender (2000-2019).

Broken down by region of death, it is striking that the mortality rate per 100,000 inhabitants due to neoplasms seems to have fallen sharply between 2000 and 2019, especially in Brussels. However, this is probably more a consequence of the change in population structure that the Brussels-Capital Region is experiencing. Compared to the other two regions, there are relatively fewer elderly people living in Brussels, which means that neoplasms could play a relatively smaller role in the mortality observed. The differences between the Flemish and Walloon Regions are less pronounced: in 2019, we can see that there were approximately 4 more deaths per 100,000 inhabitants in Flanders than in Wallonia (251.3 and 247.5 deaths respectively).

Year Flemish Region Walloon Region Brussels-Capital Region
Number Number / 100,000 inhabitants Number Number / 100,000 inhabitants Number Number / 100,000 inhabitants
2000 15,232 256.4 8,529 255.4 2,436 253.9
2001 15,168 254.8 8,711 260.3 2,434 252.4
2002 15,650 262.0 8,695 258.9 2,454 250.8
2003 15,593 260.1 8,687 257.9 2,425 244.4
2004 15,101 251.0 8,657 256.1 2,407 240.7
2005 15,615 258.4 8,715 256.6 2,305 229.0
2006 15,725 258.7 8,452 247.6 2,356 231.3
2007 15,697 256.6 8,768 255.2 2,242 217.4
2008 16,175 262.5 9,115 263.7 2,325 222.0
2009 16,237 261.5 8,923 256.7 2,365 221.3
2010 16,532 264.4 9,396 268.6 2,374 217.9
2011 16,644 263.9 9,407 266.8 2,295 205.1
2012 16,715 263.2 9,368 264.2 2,319 203.6
2013 16,849 264.0 9,598 269.4 2,270 196.6
2014 16,880 263.3 9,358 261.7 2,281 196.0
2015 16,683 258.9 9,655 269.0 2,260 192.3
2016 16,799 259.3 9,531 264.6 2,230 187.7
2017 16,666 255.8 9,357 258.9 2,252 189.0
2018 16,514 252.0 9,125 251.8 2,085 173.9
2019 16,561 251.3 8,993 247.5 2,185 180.8
Table 2: Number of deaths due to neoplasms, by region (2000-2019)

Figure 2: number of deaths per 100,000 inhabitants due to neoplasms, by region (2000-2019)

Evolution in types of neoplasms by gender

Men

Half of the deaths due to neoplasms among men in 2019 were attributable to five categories. The largest share is for malignant neoplasms of trachea, bronchus and lung (68.3 deaths per 100,000 male inhabitants). As many as one in four deaths among men caused by neoplasms is due to this type of cancer. However, a slight decrease can be observed compared to previous years (70.6 in 2018, and 71.3 in 2017). Malignant neoplasm of prostate remains relatively stable in second place (28 deaths per 100,000 male inhabitants), followed by malignant neoplasm of colon, which is again experiencing a decline (from 19.6 in 2017, to 17.5 in 2018 to 17.2 in 2019). Among men, the fourth place goes to malignant neoplasm of pancreas with 15.0 deaths/100,000, again a decrease compared to 2018 (16.9); there was then a slight increase compared to 2017 (16.1). In fifth place is a broad collection that includes all benign neoplasms, but also neoplasms of uncertain or unknown behaviour (i.e. it is not possible to unequivocally demonstrate that it is a benign or malignant neoplasm). In 2019, there were 12.2 deaths per 100,000 inhabitants identified in this category. Again, this is a decrease compared to previous years (2018: 14.1; 2017: 15.1). This category consists mainly of deaths due to myelodysplasia, malignant neoplasms of trachea, bronchus and lung and malignant neoplasms of brain.

Neoplasm (ICD-10 code) 2019 2018 2017
Number Number / 100,000 inhabitants Number Number / 100,000 inhabitants Number Number / 100,000 inhabitants
Malignant neoplasm of trachea, bronchus and lung (C33-C34) 3,843 68.3 3,953 70.6 3,970 71.3
Malignant neoplasm of prostate (C61) 1,576 28.0 1,602 28.6 1,572 28.2
Malignant neoplasm of colon (C18) 966 17.2 981 17.5 1,090 19.6
Malignant neoplasm of pancreas (C25) 843 15.0 946 16.9 897 16.1
Benign neoplasms and neoplasms of uncertain or unknown behaviour (D00-D48) 689 12.2 788 14.1 838 15.1
Malignant neoplasm of liver (C22) 618 11.0 627 11.2 600 10.8
Malignant neoplasm of oesophagus (C15) 605 10.7 564 10.1 539 9.7
Leukaemia (C91-C95) 549 9.8 530 9.5 553 9.9
Malignant neoplasm of bladder (C67) 547 9.7 580 10.4 632 11.4
Lymphoma (C81-C86) 415 7.4 393 7.0 360 6.5
Malignant neoplasms of brain and central nervous system (C70-C72) 411 7.3 377 6.7 378 6.8
Malignant neoplasm of rectum and anus (C19-C21) 399 7.1 390 7.0 442 7.9
Malignant neoplasm of stomach (C16) 392 7.0 398 7.1 418 7.5
Malignant neoplasm of lip, oral cavity and pharynx (C00-C14) 373 6.6 381 6.8 411 7.4
Malignant neoplasm of kidney (C64) 351 6.2 326 5.8 327 5.9
Other types of lymphoma (C88, C90, C96) 272 4.8 285 5.1 289 5.2
Malignant melanoma of skin (C43) 153 2.7 189 3.4 175 3.1
Malignant neoplasm of larynx (C32) 147 2.6 141 2.5 138 2.5
Malignant neoplasm of gallbladder, biliary tract (C23-C24) 66 1.2 54 1.0 57 1.0
Malignant neoplasm of thyroid gland (C73) 33 0.6 37 0.7 25 0.4
Malignant neoplasm of breast (C50) 25 0.4 21 0.4 20 0.4
Other malignant neoplasms 1,918 34.1 1,727 30.9 1,779 32.0
Table 3: Number of deaths by type of neoplasm (men, 2017-2019)
Note: all other neoplasms that are not explicitly mentioned are included in the category ‘Other malignant neoplasms’.

Women

As in the male population, more than half of deaths due to neoplasms are the result of five categories, four of which are the same, although not in the same order.

For women, malignant neoplasm of breast remains the leading cause of death among neoplasms in 2019 (35.8 deaths per 100,000 women) despite a decrease compared to 2018, when there was a slight increase (38.4) compared to 2017 (38.1). Second place goes to malignant neoplasms of trachea, bronchus and lung (34.7 deaths per 100,000 male inhabitants). In contrast to the male population, this number is on the rise (from 31.9 in 2017 to 33.3 in 2018). The third to fifth places are assigned to the same groups for both women and men. In 2019, 17.1 deaths per 100,000 women were recorded due to a malignant neoplasm of colon, which is a slight increase compared to 2018 (16.7) after a decrease compared to 2017 (17.8). Malignant neoplasm of pancreas also registers a slight increase (16.3 deaths per 100,000 inhabitants), after a decrease was already observed in 2018 (2018: 15.6; 2017: 16.5). Fifth place goes to benign neoplasms and neoplasms of uncertain or unknown behaviour (2019: 16.6). Here we do see a decrease compared to 2018 (12.0) and 2017 (13.5). For deaths among women, this mostly concerns myelodysplasia, neoplasms of the brain and neoplasms of some digestive organs such as the pancreas or oesophagus.

Neoplasm 2019 2018 2017
Number Number / 100.000 inhabitants Number Number / 100.000 inhabitants Number Number / 100.000 inhabitants
Malignant neoplasm of breast (C50) 2,075 35.8 2,220 38.4 2,195 38.1
Malignant neoplasm of trachea, bronchus and lung (C33-C34) 2,015 34.7 1,923 33.3 1,835 31.9
Malignant neoplasm of colon (C18) 992 17.1 963 16.7 1,026 17.8
Malignant neoplasm of pancreas (C25) 946 16.3 904 15.6 947 16.5
Benign neoplasms and neoplasms of uncertain or unknown behaviour (D00-D48) 618 10.6 694 12.0 774 13.5
Malignant neoplasm of ovary (C56) 611 10.5 575 10.0 606 10.5
Leukaemia (C91-C95) 441 7.6 443 7.7 474 8.2
Malignant neoplasm of liver (C22) 387 6.7 317 5.5 353 6.1
Malignant neoplasm of parts of the uterus (C54-C55) 371 6.4 383 6.6 396 6.9
Lymphoma (C81-C86) 335 5.8 323 5.6 327 5.7
Malignant neoplasms of brain and central nervous system (C70-C72) 303 5.2 262 4.5 254 4.4
Malignant neoplasm of rectum and anus (C19-C21) 298 5.1 312 5.4 309 5.4
Malignant neoplasm of stomach (C16) 238 4.1 245 4.2 270 4.7
Other types of lymphoma (C88, C90, C96) 238 4.1 270 4.7 266 4.6
Malignant neoplasm of oesophagus (C15) 226 3.9 180 3.1 199 3.5
Malignant neoplasm of bladder (C67) 215 3.7 224 3.9 245 4.3
Malignant neoplasm of kidney (C64) 203 3.5 192 3.3 196 3.4
Malignant neoplasm of lip, oral cavity and pharynx (C00-C14) 157 2.7 142 2.5 190 3.3
Malignant melanoma of skin (C43) 152 2.6 166 2.9 150 2.6
Malignant neoplasm of cervix uteri (C53) 143 2.5 175 3.0 170 3.0
Malignant neoplasm of gallbladder, biliary tract (C23-C24) 88 1.5 74 1.3 75 1.3
Malignant neoplasm of thyroid gland (C73) 41 0.7 52 0.9 29 0.5
Malignant neoplasm of larynx (C32) 28 0.5 22 0.4 24 0.4
Other malignant neoplasms 1,427 24.6 1,373 23.8 1,455 25.3
Table 4: Number of deaths by type of neoplasm (women, 2017-2019)
Note: all other neoplasms that are not explicitly mentioned are included in the category ‘Other malignant neoplasms’.

Based on statistical death bulletins, which are managed by the federated entities, the statistic on causes of death has now a homogeneous series for the period 1998-2019. This homogeneity of the series is achieved because the three federated institutions concerned use the tenth revision of the World Health Organization's International Classification of Diseases and Related Health Problems (ICD-10) to code the causes of death and to identify, among them, the initial cause on the basis of which the main tables of the statistic are produced.


[1] Within the meaning of Chapter 2 of the International Statistical Classification of Diseases and Related Health Problems of the World Health Organization (ICD-10).

[2] The ‘other natural deaths’ accounted for 4.3% of cases in 2000 and have now more than doubled in relative importance to 9.5% of cases in 2019. Mental and behavioural disorders accounted for 2.8% of deaths in 2000 and 5.3% of cases in 2019.

Deaths
Content

Belgium - Deaths by sex and by region, 2019

  Men Women Total
Brussels-Capital Region 4,167 4,749 8,916
Flemish Region 30,826 31,594 62,420
Walloon Region 18,192 19,217 37,409
Belgium 53,185 55,560 108,745
Causes
Content

Belgium - Deaths by sex and by region, for some groups of causes, 2019

  Men Women Total
Number of cases % Number of cases % Number of cases %
Brussels-Capital Region All causes 4,167 100% 4,749 100% 8,916 100%
Diseases of the circulatory system 887 21.3% 1,137 23.9% 2,024 22.7%
Tumours 1,116 26.8% 1,069 22.5% 2,185 24.5%
Diseases of the respiratory system 455 10.9% 497 10.5% 952 10.7%
Flemish Region All causes 30,826 100% 31,594 100% 62,420 100%
Diseases of the circulatory system 4,212 23.2% 4,994 26.0% 9,206 24.6%
Tumours 4,913 27.0% 4,080 21.2% 8,993 24.0%
Diseases of the respiratory system 2,185 12.0% 2,138 11.1% 4,323 11.6%
Walloon Region All causes 18,192 100% 19,217 100% 37,409 100%
Diseases of the circulatory system 4,294 23.2% 5,014 25.3% 9,308 24.3%
Tumours 4,873 26.3% 4,134 20.9% 9,007 23.5%
Diseases of the respiratory system 2,292 12.4% 2,385 12.1% 4,677 12.2%
Belgium All causes 53,185 100% 55,560 100% 108,745 100%
Diseases of the circulatory system 12,461 23.4% 14,836 26.7% 27,297 25.1%
Tumours 15,191 28.6% 12,548 22.6% 27,739 25.5%
Diseases of the respiratory system 6,403 12.0% 5,787 10.4% 12,190 11.2%
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Purpose and brief description

Statistics on causes of death are compiled using the statistical declaration-of-death forms (Model IIIC and Model IIID) which are filled in by a certifying doctor for every death that takes place in Belgium and then completed by the municipal authorities of the place of death. These forms are forwarded to the Communities which check, code and input the information in order to compile their own statistics. The databases are then forwarded to Statbel, which assembles them to compile statistics at the federal level. To this end, Statbel links the forms with the deaths registered in the RNPP. This makes it possible: to check and complete the available information; to exclude from the statistics the deaths taking place in Belgium of people who do not legally reside in the country; and, finally, to include in the statistics the deaths taking place abroad of people who legally reside in Belgium and for whom no civil status form was filled in. The aforementioned coupling and inclusion have only been effective since 2010. This means that deaths abroad of people residing in Belgium were previously not included in the federal statistics.

Since 1998, the coding of causes of deaths is carried out according to the WHO's tenth revision of International Statistical Classification of Diseases and Related Health Problems (ICD-10). All the tables of the statistics break down the deaths into various groups of causes, also making a distinction according to five-year age groups and gender.

Population

Inhabitants in Belgium

Periodicity

Annually.

Release calendar

Results available 2 years after the reference period

Definitions

Gender: Gender of the deceased

Cause of death: Original cause of death

Age groups: Age of the deceased, in five-year age groups

Region of residence: Region of residence of the deceased

Nomenclature

WHO International Classification of Diseases (ICD)

Metadata