The concept of field effects in cancer is old, but recent molecular data have substantiated it. Clones of cells that carry well-defined genetic or epigenetic aberrations, but which have not yet acquired the morphological hallmarks of neoplasia, have been documented in the precursor tissues of some of the most common pediatric and adult malignancies. Here I review this evidence, focusing on loss of heterozygosity (LOH) and gain of DNA methylation.