Cancer mortality in Itapúa-A rural province of Paraguay 2003-2012.

•Mortality from cancer outweighed mortality from infectious diseases in Itapúa, Paraguay.•Cancer mortality, especially in children, was underestimated due to lack of reliable data.•The quality and accuracy of the death certification needs to be improved.•The high mortality from cervical cancer requires preventive actions.•Tobacco control measures are needed for the primary prevention of lung cancer.