Aims: To study the incidence of primary malignant bone tumours in Western Australia (WA) from 1972 to 1996 using the database of the WA Bone Tumour Registry (BTR) and to compare these rates with those in the United States of America ( USA). In addition, to undertake a linkage study between the BTR database and that of the WA Cancer Registry (WACR) for the years 1980 - 1996 to determine if the BTR records could be regarded as population-based and valid for determining incidence rates in WA.Methods: For each year of the review, standardised incidence rates were calculated for osteosarcoma, chondrosarcoma, Ewing's sarcoma and for all bone sarcomas combined. For comparison, incidence rates were calculated using data obtained from the Surveillance, Epidemiology and End Results ( SEER) Program Registry in the USA.Results: Excluding myeloma, there were 263 cases of primary malignant bone tumours. Osteosarcoma ( 94 cases), chondrosarcoma ( 64 cases) and Ewing's sarcoma ( 49 cases), were the three most common and represented 78.7% of all primary bone sarcomas. Age-sex-standardised incidence rates for osteosarcoma in WA were 28% lower than in the USA. For chondrosarcoma and Ewing's sarcoma, no significant difference was found between rates in WA and the USA.Conclusions: The BTR provides a valuable resource for the study of primary bone tumours. This review has established reliable incidence rates for individual types of bone sarcoma. In both geographical sites there is a slight upward trend in the incidence of primary bone sarcoma.