The Silent Epidemic: A Multi-Database Analysis of Chronic Arsenic Exposure, Carcinogenesis, and Sustainable Mitigation in the Gangetic Delta

A major environmental health issue in the Gangetic Delta is undoubtedly the chronic contamination of groundwater by arsenic. Large populations-primarily those in eastern India and Bangladesh- are among those affected. This study applies a multi-database analytical framework to examine long-term arsenic exposure trends, associated cancer burden, mechanistic pathways, and mitigation patterns across the region, while incorporating district-level spatial analysis from West Bengal. Mean groundwater arsenic concentrations from the Central Ground Water Board (Pre-Monsoon 2024) were integrated with observed cancer case data from the ICMR–NCDIR West Bengal Cancer Fact Sheet (2021). District-level datasets were harmonized, and a Poisson generalized linear model was used to evaluate associations between arsenic exposure and cancer burden. A tertile-based 9-class bivariate framework was constructed to assess spatial concordance. Marked geographic heterogeneity was observed, with High–High exposure–burden concordance identified in districts including Murshidabad, North 24 Parganas, Howrah, and Hooghly. Regression analysis demonstrated a positive association between arsenic concentration and observed cancer cases. Mechanistic evidence linking oxidative stress, DNA damage, epigenetic alterations, and chronic inflammation provides biological plausibility for these ecological patterns. Although causal inference is limited by the ecological design and potential confounding factors, the integration of environmental monitoring, cancer registry data, and spatial modeling strengthens the evidence linking arsenic exposure to cancer burden and underscores the need for coordinated, preventive groundwater management across the Gangetic Delta.