Abstract Aim This study investigates the impact of gender inequality on cancer mortality among European women across 27 countries from 2013 to 2020. Subject and methods The study explores the link between gender inequality and cancer mortality, employing pooled ordinary least squares regression. It evaluates socioeconomic gaps, healthcare access disparities, risky behaviours, and elements like screening, education, and life expectancy. The study also investigates how healthcare spending, employment, self-perceived health, and leisure activities influence mortality. Results The study shows that breast and cervical cancer screenings (BCS) significantly reduce cancer-related deaths among European women (CDW), with a negative impact of −0.0875. Similarly, tertiary education and participation in education and training (WEP) show a negative impact of −0.0021. Absolute life expectancy for women at birth (LEW) demonstrates a negative impact of −5.2603, all contributing to decreased cancer-related deaths. Conversely, certain variables have a contradictory positive impact on CDW. Total healthcare expenditure (HCE) has a positive impact of +0.0311, and full-time equivalent employment (FER) of +0.3212. Women engaging in activities (WLW) has a positive impact of +0.6572. Self-perception of good health (WHG), refraining from smoking or harmful drinking (NSN) (+0.2649), and an active lifestyle with consumption of fruits and vegetables (PAF) (+0.2649) also impact positively, collectively contributing to increased cancer mortality among women. Conclusion The study highlights the importance of combating gender inequality to decrease cancer deaths in European women. Strategies include closing healthcare gaps and enhancing health education. Complex links between smoking, alcohol, and cancer mortality require further research. Interventions targeting disparities, healthcare access, and risky behaviours can notably lower cancer mortality.