The Pros and Cons of Modernization: Cancer in China

by Bill Chameides | November 6th, 2008
posted by Erica Rowell (Editor)

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Modernizing China is cutting out some forms of pollution but adding to others.

When it comes to getting cancer, is it better to live in a modern, developed economy or in an undeveloped one? Two studies from China suggest that the answer is yes … and yes.

It you want to study the impact of modernization, China turns out to be a great laboratory. What took decades or even centuries to transpire in the West has materialized in a matter of a decade or two in China. Along with large geographic disparities in economic conditions, such growth makes China ideal for doing both “before and after” and “here versus there” studies.

Progress in China but at What Price?

One such study, published in The Lancet last week, suggests that modernization reduces disease. Hsien-Ho Lin at the Harvard School of Public Health and colleagues analyzed the trend over time in the incidence of disease in China. They concluded that several diseases, including lung cancer, are associated with indoor air pollution produced from smoking cigarettes and using solid fuels (coal, wood, charcoal, or crop residues) to cook and heat in traditional, undeveloped communities in China.

So how big a health risk is household smoke for the Chinese? Consider these three findings:

  • Epidemiological studies [pdf] have shown that smoke from solid fuels like coal is a risk factor for lung cancer.
  • The 2000 census in China found that more than 70 percent of all households use solid fuels for heating and cooking.
  • In China, lung disease (in the form of chronic, obstructive pulmonary disease) and lung cancer were respectively the second and sixth leading cause of death in 2002.

Fortunately, solid fuel use in China is in decline, as modernization and economic development make liquid fuels, natural gas, and electricity increasingly available. In the late 1980s and early 1990s when I was in Beijing, the Chinese government was taking huge strides to bring natural gas to and reduce the use of coal in the city’s households. More recently, in preparation for the Olympics, all use of coal within Beijing’s “third ring” was reportedly eliminated. Still, rural areas have a long way to go.

The work of Lin and colleagues suggests that transitioning from solid fuels will vastly improve the health of Chinese lungs. By 2033, the researchers estimate, if smoking and solid fuels were completely eliminated — a big if —  deaths from these two diseases alone could be cut in half, saving the lives of about 32 million people.

Modernizing China: One Step Forward, One Step Back?

The Lancet article about the heath advantages that accompany economic development and modernization was convincing. But it left me with a nagging doubt –- something was missing. And then I remembered a 2007 study. It concluded that modernization was leading to more cases of another form of cancer in China.

Over the last decade the number of women in Beijing and Shanghai with breast cancer has increased by 20 to 30 percent. Xiaohui Cui, also from the Harvard School of Public Health, along with U.S. and Chinese colleagues undertook an epidemiological study to tease out why. In a paper published in Cancer Epidemiology Biomarkers & Prevention they concluded that the culprit is the Western “meat-sweet” diet embraced by more and more Chinese as they become increasingly affluent and urban. Post-menopausal women who ate the Western diet in place of the traditional vegetable-soy diet significantly increased their risk of contracting breast cancer.

In addition, the researchers observed that obesity, which is also on the rise in China, also correlates with an increased risk for cancer in postmenopausal women. They speculated that increased obesity from a meat-sweet eating pattern might contribute to postmenopausal cancer. I wonder if hormones and other chemicals added to cattle feed may also be a contributing factor.

When Is Progress Progress?

For me the bottom line of these two studies is that although progress is a good thing it can come with a price. The lung disease study puts the lie to pastoral notions of preindustrial folk living in an environmentally pristine world. Smoke-filled abodes and towns can cause disease and shorten lives. Returning to that way of life wouldn’t solve our environmental ills.

But modern dangers looming from factory and vehicular pollution, chemical byproducts (like endocrine disruptors), and nanoparticles present a new array of health and environmental threats — threats that could carry devastating consequences.

Perhaps that is why there are environmental scientists like me -– to separate the good progress from the bad and thereby make … well, progress.

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