SummaryThis overview of the epidemiology of chronic lymphocytic leukaemia (CLL) summarizes the evolution of classification and coding systems and describes the intersection of pathogenesis and aetiology. The role of the putative precursor to CLL, monoclonal B-cell lymphocytosis (MBL), is considered, and ideas for future investigations of the MBL-CLL relationship are outlined. We discuss the epidemiology of CLL, focusing on descriptive patterns and methodological considerations. Postulated risk factors are reviewed including the role of ionizing and non-ionizing radiation, occupational and environmental chemical exposures, medical conditions and treatments, and lifestyle and genetic factors. We conclude by raising key questions that need to be addressed to advance our understanding of CLL aetiology. Recommendations for future epidemiological studies are given, including the standardization of reporting of CLL across cancer registries, the clarification of the natural history of MBL, and the circumvention of the methodological shortcomings of prior epidemiological investigations in relation to radiation, chemical exposures and infectious agents.Keywords: chronic lymphocytic leukaemia, aetiology, radiation, chemicals, review. ). In light of these major scientific developments, it seems timely to reconsider key aspects of the epidemiology of CLL together with its similar counterpart, small lymphocytic lymphoma (SLL), which are considered different manifestations of the same lymphoid neoplasm in the WHO classification (Jaffe et al, 2001).This overview of the epidemiology of CLL includes three sections. The first section describes the evolution of classification and coding systems, the intersection of pathogenesis and aetiology, and the putative precursor of CLL, monoclonal B-cell lymphocytosis (MBL). The second section briefly characterizes the epidemiology of CLL, including descriptive patterns; the role of animal models in identifying risk factors, genetic pathways and biological mechanisms; and discusses known risk factors based on our current, albeit limited, understanding of aetiology. Descriptive and analytical epidemiological research on CLL is also considered in more detail in the accompanying reports by Dores et al (2007), SchubauerBerigan et al (2007), Blair et al (2007) and Landgren et al (2007a). The third section poses key questions pertinent to CLL aetiology and provides recommendations for future epidemiological studies.Correspondence: Martha S. Linet, NCI, DCEG, REB; 6120 Executive Blvd. EPS Room 7048,