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Continuous exposure to low doses of potentially mutagenic and carcinogenic chemicals over the human lifetime makes the identification of agents, which could reduce the ensuing risk of cancer, beneficial. The Human Epidermal Cell (HEC) Assay includes multiple exposures to low, non-toxic doses of propane sultone, which increases cellular growth and inhibits differentiation, and co-exposure to potential chemopreventive agents to determine their ability to inhibit the increased growth or increase differentiation. Original data are presented on the efficacy of twenty potential cancer chemopreventive agents were screened for efficacy in the HEC Assay. Efficacy was determined by the ability of agents, at nontoxic concentrations, to reverse either of the propane sultone-induced biomarkers, enhanced growth and reduced involucrin expression. Based on the number of positive concentrations and the lack of toxicity, 1,2-dithiol-3-thione, oltipraz, and a synthetic retinoid, Ro 16-9100, were the most active. Eleven of seventeen positive agents were active for both endpoints. S-Allylcysteine was only active for the growth inhibition endpoint, and DFMO, Iycopene, perillyl alcohol, ursodiol, and black tea polyphenols were only active for the involucrin endpoint. The three agents that have been shown to be negative in animal models, diphenhydramine, d-mannitol, and nordihydroguaiaretic acid, were correctly identified as negative by the assay. When the data from previous studies (Elmore et al, Anticancer Res, 19: 909-918, 1999) are included, a positive response in one or more endpoints of the HEC Assay correlates 100% (26/26) with a positive response in one or more of the animal cancer prevention models (8). The available data suggest that the HEC Assay response is highly predictive of efficacy in animals in vivo with an overall accuracy of 90%. Future studies will include data with additional negative agents. The correlation of the HEC Assay data with data from in vivo studies in animal models, which utilize multiple carcinogens and multiple target organs, would suggest that this in vitro assay has the ability to identify agents with the potential to prevent carcinogen-induced cancer. While our ultimate goal is to identify agents with potential efficacy for preventing human cancer, sufficient human data are not yet available to make this correlation.