A simplified overview of the molecular pathways that link genotoxicity detectable by the Comet and nuclear abnormalities (NA) assays with oncogenesis, teratogenesis and other pathological alterations as expected to occur in vertebrates, exemplified here as in co-exposure to organic mutagens (such as some PAHs and dioxins) and metals to highlight some of the potential interactions between toxicants. These pathways, albeit originally described in higher-order vertebrates, have also been described in fish.