Abstract: In the majority of cases, hypopharyngeal cancer is asymptomatic until it reaches the advanced stage, which accounts for the high incidence (70-80%) of advanced cases of hypopharyngeal cancer at initial diagnosis. However, endoscopic screening in high-risk patients, such as those with squamous cell carcinoma of the upper aerodigestive tract, may contribute to early detection of hypopharyngeal cancer. In our hospital, patients with esophageal cancer received periodic otolaryngological screening for head and neck cancer. The purpose of this study was to determine whether periodic otolaryngological screening before and after treatment of esophageal cancer is effective in detecting early stage hypopharyngeal cancer. A total of 1,790 consecutive patients with esophageal cancer were treated at Keiyukai Sapporo Hospital between May 1995 and December 2003. Of these, 80 patients had additional primary hypopharyngeal cancer. Sixty-three patients were diagnosed as having hypopharyngeal cancer by periodic otolaryngological screening, prior to which they had no subjective symptoms of hypopharyngeal cancer or lymph node involvement. The clinical stage distribution of these hypopharyngeal cancers was as follows: stage I, 43; stage II, 14; stage III, 3; stage IV, 3. Patients with stage I or II hypopharyngeal cancer comprised 90.5% of the 63 patients, which was rather higher than the reported incidence of early cases. Our findings demonstrated that periodic pharyngolaryngoscopy screening in patients with esophageal cancer can provide early detection of hypopharyngeal cancer.