In this review, issues of causality in epidemiologic research with emphasis on the aetiology of human cancer are considered. Principles of assessing causation in epidemiological studies of cancer are distinguished into those concerning an individual study, several studies and a particular person. Strengths and weaknesses of various approaches of documenting carcinogenicity in humans are examined and lists of major established causes of human cancer are presented. The review concludes with estimates of mortality from cancer around the world that can be attributed to specific factors under the light of the current scientific knowledge.