Traditional views of nutritional carcinogenesis depend on the identification of exogenous carcinogens as major risk factors. As our understanding evolves, it is clear that the pattern of events involves not only exogenous carcinogens, but also metabolic processes and endogenous and exogenous anticarcinogens. The process is modulated by the immune system, and genetics plays a significant role. New monitoring methods provide much-needed tools for providing proof of involvement of various factors at the level of human populations.