This chapter discusses a research site in the Huai River Basin, using the perspective of ‘ins and outs’ as an analytical framework. The pollution in Huangmengying Village mostly comes from upstream, but water conservancy projects, the nature of water courses and flows of pollution also have an impact. Media coverage of cancer in the area emphasized the role of external pollution from industry, but this study also found a relationship between smoking and cancer among men and between hepatitis B and liver cancer. There was also an association between drinking water and the high incidence of digestive tract diseases, which declined when the water supply was improved. The phenomenon of ‘cancer villages’ is therefore also shaped by the living conditions and lifestyle of the villagers.