High-temperature cooking techniques and doneness level of red meat are linked to cancer of various sites, particularly colorectal cancer. In a colorectal adenoma study, we found an elevated risk for red meat consumption that was mainly due to an association with well-done/very well-done red meat. High-temperature cooking methods (i.e. grilling) were also associated with increased risk. We are currently using an HCA database linked to this questionnaire to estimate MeIQx, DiMeIQx and PhIP consumption and determine their association with risk of colorectal adenoma. Similar results on red meat doneness and fried meat were found in a case-control study of lung cancer. Thus, initial positive findings are stimulating the development of a more refined questionnaire instrument and its validation using food diaries, 24-h recalls, biomarkers of internal dose and direct food measurements. Furthermore, the use of these exposure assessment approaches are being used in large prospective studies world wide and should help clarify the role of doneness, cooking practices and pyrolysis products in the etiology of human cancer.