The report by the Canadian Institute for Health Information (CIHI) says 47 out of every 100,000 women die of lung cancer each year in Canada.
That's almost double the average rate of 26.5 per 100,000 for the 34-country organization, with only Iceland and Denmark showing higher rates.
CIHI says the death rate may be linked to higher smoking levels among women in the 1980s; it takes up to 30 years for drops in smoking rates to translate into reduced lung cancer cases.
In the 1980s, almost a third of Canadian women smoked daily, compared to 14 per cent in 2010.
The lung cancer death rate for Canadian men remains higher than women's at 72.3 per 100,000, but is much closer to the OECD average of 66 per 100,000.
Male smoking rates began falling in the 1960s, and Canada today has among the lowest rates of tobacco use by men within the OECD — 17 per cent versus an average of 26 per cent among member countries, the report shows. The OECD average for women is 16 per cent.
"Lung cancer is the leading cause of cancer death in Canada, with an expected 20,200 lung cancer deaths in Canada this year," said Dr. Heather Bryant, vice-president of cancer control at the Canadian Partnership Against Cancer.
"While lung cancer mortality rates have been declining for men for some time, they have not yet shown the same pattern for women," she said.
"Studies like this one are intended to encourage conversations and identify areas for improvement."
When it comes to health indicators, Canada's performance varies from among the best to among the worst in the OECD comparison of countries, but no country outperforms Canada across all categories.
Relative to other OECD countries, Canada gets high marks on several indicators, including potentially avoidable hospital admissions for diabetes and asthma, deaths from stroke, current smoking rates, and fruit and vegetable consumption, the report found.
However, Canada underperforms many other countries on diabetes and obesity rates — about one-quarter of Canadian adults are considered obese — and on most patient-safety indicators, particularly obstetric trauma and foreign bodies left in patients during surgical procedures.
"Canada's performance is among the worst for foreign bodies left in after surgery," the authors write.
"These foreign bodies mostly include sponges or parts of medical devices ... Nearly all peer countries outperform Canada, with the exception of New Zealand and Australia."