The cyclin-dependent kinase inhibitor p16 (p16 INK4A / CDKN2/MTS1) is a potent inhibitor of the cyclin Ddependent phosphorylation of the retinoblastoma gene (Rb) product, the inactivation of which induces loss of Rb-dependent G1 arrest through inappropriate phosphorylation of the Rb protein. To analyse the role of p16 INK4A as a tumor suppressor in the genesis of non small cell lung cancers (NSCLC) and correlate loss of p16 INK4A protein expression to genetic or epigenetic mechanisms, we have performed a comprehensive study of p16 status in a series of 43 NSCLC. To this end, we have investigated p16 INK4A protein expression with immunohistochemistry, deletions of the gene by FISH, and determined the methylation status of exon 1a using a PCR-based methylation assay. Finally, possible mutations were studied by SSCP and subsequent sequencing. Twenty one of the 43 (49%) NSCLC studied exhibited an absence of p16 INK4A nuclear staining. Of these, three (14%) had frameshift or missense mutations, seven (33%) displayed methylation of exon1a and 10 (48%) displayed homozygous deletions. In total, 95% of the tumors with p16 INK4A negative staining carried one of these three alternative genetic or epigenetic alterations. Furthermore, a high degree of chromosome 9 polysomy was found (58%) in those tumors with p16 INK4A inactivation. Taken together these results suggest that deregulation of the p16 gene locus is a frequently occurring event in NSCLC through distinct mechanisms including rare point mutations, promotor methylation and frequent homozygous deletions. Furthermore, our data show that immunohistochemistry is a rapid and an accurate technique for screening of p16 INK4A gene inactivation events that result in loss of protein expression.