It is difficult for medical science to establish a clear relationship between cancer and pollution at the village level due to the small population size and the multi-causality of many cancers. But ‘cancer villages’ nonetheless exist as a social fact and they continue to affect the lives of villagers. In the face of health risks, and uncertainty about them, villagers try to avoid pollution by getting polluting industries to shut down or relocate, moving away themselves, and changing their water sources and diet. Economic circumstances affect the degree to which they can deploy these various strategies. Their responses are also shaped by the inherited social structure, including the power of the village clan, local ‘gentry’, and the work unit.