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Arsenic in groundwater: what it means for your liver | CION Cancer Clinics
Arsenic in borewell or hand-pump water can raise the risk of liver cancer, but it is a far smaller cause than hepatitis B, hepatitis C, alcohol or fatty liver. Its clearest links are with skin, bladder and lung cancer. Unlike most risks, it can be changed. This page explains what arsenic does, how to get your water tested, and what to tell your doctor. At CION Cancer Clinics, our specialists help you understand your own risk and plan regular liver checks that fit it.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed October 2026, next review due October 2027
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On this page
- Can arsenic in well water cause liver cancer?
- How does arsenic harm the liver and the rest of the body?
- How do I find out if our water has arsenic, and what then?
- What do the terms on a water or liver report mean?
- What do families get wrong about arsenic in water?
- What this page cannot tell you
- Common questions about arsenic and liver cancer
The short answer
Can arsenic in well water cause liver cancer?
Yes, it can, but it is a less common cause than hepatitis B, hepatitis C, alcohol or fatty liver. Drinking water with high arsenic for many years is firmly linked to cancers of the skin, bladder and lung. The link with the liver is real but weaker, and it is strongest for a rare liver cancer called angiosarcoma.
Where the arsenic comes from
Arsenic is a natural part of some rocks. In certain areas it dissolves into the water held deep underground, so a borewell or hand pump can draw it up. You cannot see, smell or taste it. Water that looks perfectly clear can still carry it, and only a test will tell you.
Why this page matters even if your risk is low
Unlike your genes or your age, the water your family drinks can be changed. That makes arsenic one of the few liver cancer risks you can do something about this week. If you already have a liver scan report, this page is about the cause of primary liver cancer, which starts in the liver. Cancer that spread to the liver from elsewhere is explained on primary versus secondary liver cancer.
Arsenic is one risk among several. Hepatitis B remains the biggest single cause of liver cancer in India.What arsenic does
How does arsenic harm the liver and the rest of the body?
Arsenic does its damage slowly. Most of the harm comes from drinking it every day for many years, not from one glass.
The skin shows it first
Long exposure often leaves dark and pale spots on the chest and back, and hard, rough patches on the palms and soles. Doctors treat these changes as a warning that the whole body has been exposed.
The liver can scar
Arsenic can damage the small blood vessels inside the liver. Over time this can raise the pressure in the portal vein, the large vein carrying blood from the gut to the liver, even when there is no cirrhosis.
Signs this has happened
- An enlarged spleen on a scan
- Swelling of the abdomen with fluid
- Swollen veins in the food pipe, found on endoscopy
Cancer risk rises in several organs
Inorganic arsenic is classed as a cause of cancer in people. The skin, bladder and lung carry the clearest risk. The liver, kidney and prostate are also linked, though the evidence is thinner.
Other illness comes with it
Long exposure is also tied to heart and blood vessel disease and to diabetes. Diabetes in turn raises the risk of fatty liver, which adds to liver cancer risk by a separate road.
Not sure whether this applies to you?
Ask an oncologistWhat you can do
How do I find out if our water has arsenic, and what then?
Find out where your drinking water really comes from
Piped water from a treated government supply is tested by the supplier. A private borewell, an open well or a village hand pump is usually not tested unless someone asks.
Ask for a water test
Your panchayat, municipal office or the district rural water supply department can tell you whether arsenic has been found in your area and where a sample can be tested. Private laboratories also test water. Ask specifically for arsenic, because a routine test may not include it.
If the result is high, change what you drink and cook with
Switch drinking and cooking water to a safe source. Boiling does not remove arsenic. It concentrates it as the water evaporates. Some household filters designed for arsenic do work, but only if they are maintained as the maker says.
Tell your doctor about the exposure
Mention how long the family drank that water. If anyone has the skin changes described above, or already has liver disease, the doctor may suggest a liver scan and blood tests.
Keep up any liver checks you were already advised
If you have hepatitis B, hepatitis C or cirrhosis, arsenic is an extra reason to stay on the six-monthly checks explained in who needs liver cancer screening.
Words you may hear
What do the terms on a water or liver report mean?
- Inorganic arsenic
- The harmful form found in groundwater. It is the form linked to cancer, and the one a water test measures.
- Arsenicosis
- Illness caused by long exposure to arsenic. It usually shows first as skin spots and thick patches on the hands and feet.
- Angiosarcoma of the liver
- A rare cancer of the blood vessel lining inside the liver. It is the liver cancer most clearly linked with arsenic and certain industrial chemicals.
- Hepatocellular carcinoma (HCC)
- The commonest primary liver cancer, starting in the main liver cells. Its link with arsenic is less certain than its link with hepatitis.
- Non-cirrhotic portal hypertension
- Raised pressure in the portal vein without cirrhosis. Long arsenic exposure is one known cause.
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Commonly believed
What do families get wrong about arsenic in water?
"Our water is sweet and clear, so it is safe."
Arsenic has no taste, colour or smell. Clear, sweet water from a deep borewell can still carry it. Only a laboratory or a proper field kit can tell you.
"Boiling the water will remove it."
Boiling kills germs, not arsenic. As water boils away, the arsenic left behind becomes more concentrated. A safe source or a filter built for arsenic is what helps.
"We have drunk it for years, so the damage is done and changing is pointless."
Stopping exposure still helps. Risk builds with the total amount taken in over a lifetime, so every year of safer water counts. Skin changes can also settle after the exposure stops.
"If someone in the family got liver cancer, it must be the water."
Usually it is not. Hepatitis B, hepatitis C, alcohol and fatty liver cause far more liver cancer. Each of these should be checked, because some of them affect other family members too.
Being straight with you
What this page cannot tell you
It cannot tell you whether the water in your village or colony has arsenic. Levels can differ between two borewells in the same street, and only a test answers that. It also cannot tell you whether a cancer in your family was caused by water. Doctors can rarely pin one cancer on one cause, and most people with liver cancer have more than one risk.
Who this does not apply to
If your household drinks treated piped water, or water already tested and found safe, arsenic is very unlikely to be your concern. Your time is better spent checking for hepatitis B and C and looking after your weight and drinking, as set out in lowering your liver cancer risk.
Who can help
Your local water authority can test the water. A physician or hepatologist can examine the skin and order liver tests. If a liver scan has already shown something, a CION oncologist can review the report with you and, where needed, CION arranges further scans through accredited diagnostic partners.
Evidence on arsenic and the commonest liver cancer is still limited. We say so plainly rather than overstate it.Questions we are asked
Common questions about arsenic and liver cancer
Is arsenic in groundwater a problem in Telangana and Andhra Pradesh?
The best-known arsenic belt in India lies along the eastern Ganga and Brahmaputra plains. Telangana and Andhra are better known for fluoride in groundwater, though arsenic has been reported in some pockets. The only way to know about your own well is to test it, whatever the district.
Does an RO filter remove arsenic?
A well-maintained reverse osmosis unit removes much of the arsenic in water, and some filters are made specifically for arsenic. Candle, cloth and sand filters do not. Any filter stops working properly if the parts are not changed on time, so retest the filtered water once it is in use.
Can rice grown with arsenic water add to the risk?
Rice takes up arsenic from contaminated irrigation water more than most crops. Washing rice well and cooking it in plenty of safe water, then draining the extra, lowers the amount. In most households, drinking water is still the bigger source to fix first.
Is there a blood test for arsenic?
Urine tests show recent exposure. Hair and nail tests show exposure over a longer stretch. A doctor will decide which, if any, is useful. None of them can tell you whether you will get cancer, so testing the water is usually the more useful first step.
Should someone exposed to arsenic have liver cancer screening?
Arsenic exposure on its own is not a standard reason for regular liver cancer screening. Screening is advised mainly for people with cirrhosis or certain kinds of hepatitis B. If you have arsenic skin changes or an enlarged spleen, ask your doctor whether a liver scan makes sense for you.
Are children more at risk?
Children drink more water for their body size, and exposure early in life is linked to more illness later. That makes safe water for children a priority. It does not mean a child exposed in the past is bound to become ill, and switching the water now still helps.
Is arsenic in some traditional medicines the same problem?
It is the same metal, and some traditional preparations have been found to contain heavy metals. Tell your doctor everything you take, without worrying about being judged. This is covered in more detail on heavy metals in traditional medicines.
Who should I call if I am worried about a liver report?
If a scan or blood test has already shown a liver problem, call the CION helpline. A CION oncologist can go through the report with you, explain what it means, and help plan any further scans, which CION arranges through accredited diagnostic partners.
Your Specialists
Meet CION's liver cancer specialists. Bring your scan reports and liver blood tests.
Our medical and surgical oncologists plan liver cancer care together, weighing the tumour and how well your liver works before choosing surgery, a liver-directed procedure or medicines.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- World Health Organization — Arsenic
- American Cancer Society — Arsenic and Cancer Risk
- American Cancer Society — Liver Cancer Risk Factors
- National Cancer Institute — Liver Cancer Causes, Risk Factors, and Prevention
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Aflatoxin: mould on groundnuts, maize and chilliesThe other environmental liver risk common in Indian homesCan you lower your liver cancer risk starting today?The changes that matter most, in orderWho needs liver cancer screening?Whether regular liver scans apply to youHidden alcohol and heavy metals in some traditional medicinesArsenic and other metals from a different source
Talk to us
Worried about a liver report after years on well water?
Tell us what the scan or blood test showed and how long the family drank that water. A CION oncologist can go through it with you and help plan any next tests. One helpline serves every CION centre.