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In England, hypopharyngeal cancer has an ASR of 0.63 per 100,000 population and accounts for < 10% of the overall annual new head and neck cancer [17]. The ASR is considerably higher in Merseyside and Cheshire – 1.14 – and the lowest in Dorset – 0.32 [18]. Between the period 1995 and 2011, the ASR for cancer of the hypopharynx increased in men but decreased in women. It is projected that there is expected to be a 10% increase in population; the numbers of head and neck cancers is projected to remain relatively stable for women but increase for men [18].

Table 1. Changes in the incidence by national cancer registry data of hypopharyngeal cancer over a fixed time period

The Netherlands Cancer Registry covering the period 1989–2011 reports that the incidence of hypopharyngeal cancer had increased [19]. The APC was significantly increased for men and women. The most prominent increase was for carcinoma in the piriform sinus in females (+2.9%). Regarding young adults, a decreasing trend was noted; this trend was statistically significant, though the absolute numbers were small.

The Denmark Population-Based Cancer Registry Database reported [20] from 1978–1982 to 2003–2007 that the ASR of hypopharyngeal cancer had increased for men and for women. It was remarked that during the “past decades” the level of exposure of the Danish people to the traditional risk factors has not increased. The prevalence of smoking had decreased since the 1970s and oral hygiene had improved. They also remarked that the Danish population had a higher alcohol intake than other Scandinavian and many European countries, but alcohol consumption since the 1970s had remained stable. The authors concluded that the significant increasing trends in several sites of the head and neck cannot be sufficiently explained by current environmental factors.

In Taiwan, The National Population-Based Cancer Registry between 1980 and 2014 reported that an average annual percentage change using World-Standarised Incidence Rate for hypopharyngeal cancer for men increased for men and women. The authors anticipate that hypopharyngeal cancer will plateau after 2030 [21, 22].

The Korean Central Cancer Registry [23] reported that between 1999 and 2009, the ACR for men and women has also reduced. One of the major contributing factors identified for this reduction is a major decline in the smoking prevalence, which has fallen from 66% in 1998 to 47% in 2009 in men and has further decreased to 39% in 2011. The prevalence of smoking in women in the early period (1990s), which was stable between 5 and 7%, had fallen to 1.8% by 2011.