Abstract There is increasing evidence that, for many cancers, the survival of socioeconomically deprived patients is worse compared with those who are more affluent. This study provides additional evidence that this is true for patients with head and neck cancers. However, the detrimental effects of deprivation were not found to be lifelong, and in this study, were confined to the first 12–18 months after diagnosis. After this there were no significant deprivation-associated effects on subsequent survival. The reasons for the initial increased mortality in the deprived are not clear but may be related to more advanced stage, more biologically aggressive cancers, greater co-morbidity or worse treatment. Copyright 2002 The Royal College of Radiologists. Published by Elsevier Science Ltd. All rights reserved.