Objectives Cancers remains a major cause of morbidity and mortality in the world today. The global burden of cancer is expected to continue to increase with much of the burden being borne by developing countries. This study presents the trends in lung cancer (and all respiratory cancers) mortality for the South African national population, and by gender.

Methods Using the country's annual mortality and population estimate data from Statistics South Africa, we calculated lung cancer and all respiratory cancers age-adjusted mortality per 100 000 people for the period 1995–2008. The South African population structure for the year 2001 was used as the reference population. To determine trends in mortality, scatter plots were plotted and regression models were fitted to assess for linear trends in the age-adjusted cancer mortality for the period. This was done for the entire population and by gender.

Results Lung cancer caused 61 418 deaths and other respiratory cancers, 6 445 deaths, during the study period. Males accounted for 70.5% of lung cancer deaths and 71.7% of all respiratory cancer deaths. The majority of deaths (56%) were in the 50–69 year age group. While the age-adjusted lung cancer mortality for males decreased by 23.1%, the rates for females increased by 26.4%. Similar gender differences were observed for all respiratory cancers.

Conclusions The declining lung cancer mortality in men is welcome but the increasing rate in women is a public health concern and requires intervention.