Objective: The purpose of this study was to examine the oropharyngeal cancer pattern among different ethnic groups in Taiwan. Methods: The sample population was divided into three ethnic groups: the Fukkien, Hakka, and aboriginal communities. Age-standardized mortality rates (SMRs) and age-standardized incidence rates (SIRs) were estimated among these ethnic groups for the period 1979-1996/1997. Results: Our study found that the higher oropharyngeal cancer mortality and incidence rates in females of aboriginal groups are statistically significant, and higher than reference groups for both genders (SMR = 3.76, SIR = 2.18). However, in the Lower areca quid chewing aboriginal groups, the higher pattern was not seen in females, and the tower pattern was even found in mates. The incidence and mortality rate of oropharyngeal cancer in Hakkas was significantly Lower than in the reference group. Conclusions: The pattern of oropharyngeal cancer in Taiwan showed ethnic differences. The differences may be due to variation in exposure to different risk factors; however, in our study, we found that genetic differences might also be considered when explaining the different oropharyngeal. cancer patterns among ethnic groups. (c) 2007 The Royal Institute of Public Health. Published by Elsevier Ltd. All rights reserved.