Summary The International Agency for Research on Cancer has coordinated a worldwide study of childhood cancer incidence, with data from over 50 countries. We present here the results on renal tumours. Wilms' tumour was the most common malignant kidney tumour in all regions. It is sometimes considered to be an 'index cancer of childhood' but it is clear from the present study that there is at least a threefold difference in incidence between the age-standardised annual rates of over 10 per million in the Black populations in the United States and Nigeria and those of around three per million in several East Asian populations. In White Caucasian populations, Wilms' tumour had an annual incidence of 6-9 per million, accounting for 5-7% of all childhood cancer. It was almost everywhere equally common in boys and girls, but the sex ratio in East Asia was M/F = 1.4:1. Age distributions were similar among White Caucasian and Black populations, with the peak incidence in the second year of life. In East Asia, however, 25-40% of the total incidence occurred in infants aged under I year, compared with around 15% in many Western series. Other studies have shown that, in the United States, Wilms' tumour has a lower incidence among Asian children than among Whites or Blacks and tends to occur at a younger age. The variation in patterns of incidence of Wilms' tumour along ethnic rather than geographical lines suggests that genetic predisposition is important in its aetiology. Renal carcinoma in childhood is rare throughout the world, with little sign of international variation. It accounted for a higher proportion of childhood renal tumours in East Asia but this was attributable to the lower incidence of Wilms' tumour in that region.The International Agency for Research on Cancer (IARC) recently coordinated the first comprehensive worldwide study of childhood cancer incidence in which data were collected wherever possible from population based registries and diagnostic groups were defined according to histology (Parkin et al., 1988a). The study included data from some 50 countries and a summary of some of the principal findings has been given elsewhere (Parkin et al., 1988b).Wilms' tumour is by far the commonest form of malignant kidney tumour in childhood. At one time it was believed to have a relatively constant incidence throughout the world and was thus proposed as an 'index tumour' of childhood (Innis, 1972). It was clear from the IARC study, however, that there is a three-to four-fold variation in the incidence of Wilms' tumour between different regions and ethnic groups. In this paper we present a more detailed account of the results for Wilms' tumour and other childhood renal tumours.
Materials and methodsA detailed description of the methods used in collecting and coding the data is given in the monograph on the IARC study (Parkin et al., 1988a). The series included in the monograph all contained at least 200 cases of childhood cancer. Wherever possible, series were used from populationbased registries which were bel...