Summarized recent data on the polymorphism of the xenobiotic metabolism and detoxification enzyme (XMDE) system in humans are presented. The current notions on the molecular mechanisms of metabolic processes and the role of genetic polymorphism are reviewed. The roles of transport proteins and nuclear receptors in the regulation of the activity of the XMDE system are shown. The possibilities of using the polymorphism of the XMDE system as the basis for predicting the risk of oncological diseases are considered. Experimental modeling of different levels of the epoxide synthetase and epoxide hydratase activities revealed their close relationship with the toxic, mutagenic, and carcinogenic actions of polycyclic aromatic hydrocarbons. The data indicating the necessity of considering the physiological factors that could influence xenobiotic metabolism and the development of pathological changes are given.