Background: The burden of cancer is on the rise and its epidemiology varies across different regions. Aims: To explore the epidemiology of cancer mortality in Iran, the current study examined data from 2004 to 2018 for the population served by Sabzevar University of Medical Sciences. Methods and results: This study collected data on cancer mortality using a registration system that classified the causes of death. The information was evaluated and analyzed using IBM SPSS Ver.22 at a significance level of 0.05, based on the ICD10 classification system. Over a period of 15 years, the mortality rate for all causes was 848.54 per ten thousand people, while the rate for cancer was 96.57. The median age of those who died from cancer was 68 years and it was higher for men than women. The age group with the highest cancer mortality rate was between 61 and 80 years old. Stomach, lung, and liver cancers were the most common fatal cancers, but their order varied depending on gender and region of residence. Throughout the entire 15-year period, the mortality rate for cancer in rural areas was reported as 116.12 per ten thousand people, while in urban areas it was 82.01. For men and women, the rates were reported as 111.50 and 81.18 respectively. The mortality rates for cancers of the esophagus, colon, pancreas, lung, breast, prostate, bladder and central nervous system were increasing over time while those for stomach, larynx and cervix were decreasing. Conclusion: It is of utmost importance to have health plans and policies in place that focus on preventing, detecting early, and treating cancers that have high mortality rates. These policies should take into account factors such as age, gender, and location. As cancer mortality rates change over time, it is essential to update health policies and decisions accordingly.