The Chinese government has acknowledged the existence of "cancer villages": areas where rates of cancer are unusually high, probably because of industrial and agricultural contamination of drinking and irrigation water.
The reference to the cancer clusters was in China's first ever five-year plan for environmental management of chemicals, released on 20 February. The Chinese media, translating parts of the report, said it links water pollution to "serious cases of health and social problems like the emergence of cancer villages in individual regions".
The term has caught on over the past few years as the media in China and elsewhere reported on apparent cancer hotspots. It gained prominence in 2009 when a journalist plotted 40 of them on a Google Map. Some reports have suggested there might be more than 450 such clusters.
According to recent data, deaths from cancer in China increased by 80 per cent between 1970 and 2004. The disease now accounts for 25 per cent of deaths in cities and 21 per cent in rural areas. However, people in China have an 18.9 per cent risk of getting cancer before the age of 75, compared with 29.9 per cent for people in the US and 26.3 per cent in the UK.
One "typical cancer village", as it was called by researchers from Dezhou University in Shandong province who studied it in 2008, had between 80 and 100 deaths from cancer over five years in a population of only 1200.
But proving a link between pollution and cancer requires more detailed evidence, says Tim Driscoll, an epidemiologist at the University of Sydney and science adviser to Cancer Council Australia. However, Driscoll also says it doesn't really matter – if there is dangerous pollution anywhere, it should be cleaned up.
And that is the plan. China's Ministry for Environmental Protection has drawn up a list of 58 chemicals that will be tracked with a registry, including known and suspected carcinogens and endocrine disrupters. Before the end of the 2015, they will subdivide the list into chemicals to be eliminated and those to be reduced.
Big shift
Creating a plan to eliminate some chemicals is a big shift, says Yixiu Wu, a Greenpeace East Asia campaigner based in Beijing, who says even committing to controlling these chemicals would have been a step forward.
The ministry's acknowledgement of the problem is "really important and it is another reflection of the government's shift towards more transparency in pollution information," says Sabrina Orlins from the Institute of Public and Environmental Affairs, a non-profit body in Beijing.
"Increased environmental information leads to increased public awareness where people can have the chance to exert pressure on big water polluters to adopt clean-up measures and be more accountable," she says.
That accountability is where the five-year plan is lacking, says Wu. "It is still a question whether the government is willing to release all the information about the factory locations and their environmental risk," she says. "It is very important for people who are living nearby."
Wu says the motivation to develop the plan comes from an increasing awareness of the human cost of pollution as well as the country signing up to several international conventions designed to curb pollution.
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