The Great Lakes Water Quality Agreement defines Areas of Concern as geographic areas that fail to meet the general or specific objectives of the agreement where such failure has caused or is likely to cause impairment of beneficial use of the area's ability to support aquatic life. One of the beneficial use impairments, fish tumors or other deformities, is defined by the International Joint Commission to occur when the incidence rate of fish tumors and other deformities exceeds rates at unimpacted or control sites, or when survey data confirm the presence of neoplastic or preneoplastic liver tumors in bullhead or suckers. Brown bullhead, a benthic species with a limited home range, have frequently been used as indicator species in U.S. Areas of Concern. While there is strong field evidence for an association between PAH exposure and hepatic neoplasia in brown bullhead, laboratory investigations would strengthen the association. There is less evidence linking specific classes of chemicals in the environment to orocutaneous neoplasia in brown bullhead. Studies on orocutaneous neoplasia of brown bullhead should focus on assessing the presence or absence of viruses and on epidermal exposure to specific chemicals and chemical mixtures. Lastly, the effects of covariates such as length, age, and gender on the prevalence of liver and skin neoplasms should be investigated. This paper reviews the state of science on the fish tumors or other deformities beneficial use impairment. Subsequent papers address specific issues related to this impairment and provide recommendations for standardized criteria.