Objectives: Our aim was to provide an up-to-date and review the incidence and mortality of oral and pharyngeal cancer in Europe.

Methods: Data were retrieved from both national and regional population-based cancer registries. The online browser used in the present study was the European Network of Cancer Registries (EUREG. Version 1.0), which provided data for 22 countries of Northern and Eastern Europe and for 20 countries of Western and Southern Europe on the incidence of and mortality for oral and pharyngeal cancer. For countries not included in EUREG, data were retrieved from the European Cancer Estimates (EUCAN), the Global Cancer Estimates (GLOBOCAN) and Cancer Incidence in Five Continents. Oral cancer sub-sites were classified according to International Classification of Diseases and Related Health Problems, 10th Edition categories.

Results: Hungary recorded highest rates among European countries for both morbidity and mortality. Historically, France has had high rates particularly in areas in the north of France, where oral cancer was the most common in men. A decline in the incidence has been noted in the past one and half decades. However, France still has the highest incidence rates of orophayngeal cancer, one of the highest in the world. Denmark records high rates of oral cancer in women and lip cancer incidence is high in Spain.

Conclusions: In Europe, regional differences in oral and pharyngeal cancer in terms of incidence and mortality are evident not only between north and south and between east and west but also within single regions (e.g. between the Scandinavian countries and the former Soviet republics). These findings reflect differences in lifestyle and in exposure to risk factors such as smoking (e.g. high incidence in Danish women), alcohol (e.g. in Lithuanian men) or both (e.g. Belgium and Portugal). Other traditional factors, such as actinic radiation, are responsible for a considerable number of cases of lip cancer (e.g. Spain), and oncogenic potential of human papillomavirus explains the rising trend in oropharyngeal cancer in some countries (e.g. Denmark and Scotland).