This study investigated the combined impact of air and surface water pollution on cancer incidence in China using data from 377 million people across 30 provinces. A spatial evaluation system (SESEC) was developed to harmonize nationwide data on air, surface water, and cancer incidence. A graded scale of co-pollution was created to quantify the combined effects. A dose-response relationship was observed between the degree of co-pollution and both the number of affected cancer types and cancer incidence. An estimated 62,847 (7.4%) new cancer cases in 2016 were attributable to air and surface water pollution, with the majority occurring in areas with the highest co-pollution levels. The findings highlight the interconnectedness of environmental factors and their impact on cancer and support the need for cooperative environmental governance and disease prevention policies.
