At its most fundamental, cancer is a genetic disease resulting from inherited or acquired mutations in tumour suppressor genes and proto-oncogenes. Environmental factors, including ingested food components, interact with genetic inheritance to determine individual cancer risk. There is growing evidence that the immune system exerts selective pressure during neoplastic development. Tumour cells that evade this immunosurveillance because they are non-antigenic or because they defend themselves successfully against immune attack have a survival advantage. Effective chemopreventative agents will include dietary components that enhance the immune system's ability to identify transformed cells and to target them for apoptosis.