Thirteen per cent of oropharyngeal carcinoma patients (n = 23/178) developed a secondary carcinoma, and 10% of hypopharyngeal carcinoma patients (n = 11/113). The latency time of occurrence of the second carcinoma was 37 months for the oropharyngeal tumors and 25 months for the hypopharyngeal tumors. The main location of the secondary cancers was the oral cavity and oropharynx. Early recognition of secondary cancers by routine follow-up examinations made surgical removal possible in most of the patients. The post-operative survival time for the oropharyngeal lesions was 59 months and was 34 months for the hypopharyngeal cancers. Distant metastases were found in 13% of the patients with oropharyngeal cancers and in 17% with hypopharyngeal cancer and were mainly located in the lungs. After diagnosis of distant metastases patients with oropharyngeal lesions died within 4.5 months and those with hypopharyngeal tumors died within 9 months.