Cancer of the larynx and hypopharynx are uncommon with a UK annual registration of approximately 2000 new cases. In the Medical Directory of 1983 are registered 500 otolaryngologists, each of whom was sent a postal questionnaire enquiring about 'new' laryngeal and hypopharyngeal cancers seen in 1984. Out of 114 replies, only 87 (17.4% of 500) were useful for analysis. Each respondent saw an average of eight 'new' larynx and three 'new' hypopharynx cancers. The majority of cases were treated by radiotherapy, but with increased dedication to oncology more patients with hypopharyngeal cancer were treated by surgery. The non-responders could only, on average, have seen three 'new' larynx and seldom a 'new' hypopharynx cancer. The need for a combined Head and Neck Oncology service has been identified, and should depend on subregional population needs. It is suggested that all patients with head and neck cancer be referred for specialist opinion concerning the suitability of treatment for cure or palliation.