The chemistry and molecular biology of DNA adducts is only one part of the carcinogenic process. Many other factors will determine whether a particular chemical will exert a carcinogenic effect. For example, the size of particles upon which a carcinogenic may be adsorbed will influence whether or not, and if so where, deposition within the lung will occur. The simultaneous exposure to several different agents may enhance or inhibit the metabolism of a chemical to its ultimate carcinogenic form (Rice et al., 1984; Smolarek and Baird, 1984). The ultimate carcinogenic metabolites may be influenced in their ability to react with DNA by a number of factors such as internal levels of detoxifying enzymes, the presence of other metabolic intermediates such as glutathione with which they could react either enzymatically or non-enzymatically, and the state of DNA which is probably most heavily influenced by whether or not the cell is undergoing replication or particular sequences being expressed. Replicating forks have been shown to be more extensively modified than other areas of DNA. Another critical factor which can influence the final outcome of the DNA damage is whether or not the modifications can be repaired. If this occurs with high fidelity and the cell has not previously undergone replication then the effect of the damage by the carcinogen is likely to be minimal. The major area in which progress is needed is an understanding of what this damage really does to the cell such that after an additional period of time, which may be as long as twenty or more years, these prior events are expressed and cell proliferation occurs. Clearly additional stimulatory factors, for example tumor promoting agents such as the phorbol esters or phenobarbital, are often needed. After such prolonged periods it seems likely that the DNA adducts would no longer be present. However, the way in which their earlier presence is remembered is not clear. Simple mutations do not explain all the characteristics of tumor progression and, when it occurs, regression. Even if a specific site mutation does occur then its expression must be under other types of control. Any explanation of the action of DNA modification at the molecular level also requires that account be taken of the diverse nature of the DNA adducts from simple modifications such as methylation to bulkier adducts such as benzo[a]pyrene, aflatoxin or aromatic amines.(ABSTRACT TRUNCATED AT 400 WORDS)