A review of the literature indicates that black children in the United States have a lower overall incidence of cancer and are less prone to leukemia and certain solid tumors, including neuroblastoma, rhabdomyosarcoma, Ewing's sarcoma, testicular tumors, liver tumors, and malignant melanoma, than are white children. Black children with acute lymphoblastic leukemia and retinoblastoma, but not with neuroblastoma, Wilms' tumor, and rhabdomyosarcoma, have poorer survival rates than white children. Socioeconomic status appears to be an important reason for the discrepant outlook, but genetic differences may also play a role. Consideration of these issues will assist in planning appropriate treatment regimens.