Year: 2026 | Month: January-March | Volume: 11 | Issue: 1 | Pages: 316-327
DOI: https://doi.org/10.52403/ijshr.20260133
The Changing Landscape of Liver Cancer in India: A Comprehensive Analysis of the Global Burden of Disease Study 2023
Har Ashish Jindal1, Sagar Raut2, Thejas K Santhosh3, Nancy4
1Assistant Professor, Department of Community Medicine & SPH, PGIMER, Satellite Centre, Sangrur, Punjab.
2Assistant Professor, Department of Radiotherapy, PGIMER, Satellite Centre, Sangrur, Punjab.
3Senior Resident, Department of Family Medicine, PGIMER, Chandigarh.
4Senior Resident, Department of Pathology, PGIMER, Satellite Centre, Sangrur Punjab.
Corresponding Author: Dr Har Ashish Jindal
ABSTRACT
Background: In India, liver cancer poses a major public health concern, with changing causes and geographical heterogeneity involved. To analyze the most recent trends, we assess the most recent Global Burden of Disease (GBD) 2023 estimates.
Methods: The most recent GBD 2023 (estimates) for India and the 31 States/Union Territories (UTs) from 2019-2023 and a secondary analysis of GBD 2023 (estimates) were conducted. Age Standardised Rate (ASR) of incident, mortality, prevalence and disability-adjusted life years (DALYs) were measured. ASR of the aetiological factors (hepatitis B virus (HBV), hepatitis C virus (HCV), alcohol, non-alcoholic steatohepatitis (NASH), were analysed. Male and female and State-wise variations were assessed along with evidence from 76 publications in a systematic review.
Results: From 2019 to 2023, age-standardized mortality jumped 13.0%, incidence 11.4%, prevalence 10.0%, and DALYs 13.8%. The male burden was 2.1-2.4 times higher than for females. Liver cancer in 2023 was attributed to Hepatitis B (18.3%) of total deaths, followed by alcohol use (13.6%), Hepatitis C (10.2%), and NASH (5.9%). Disparities in mortality were observed by state, with deaths per 100,000 people in Gujarat (2.55) vs. Arunachal Pradesh (33.89). The review noted that HBV's contribution to mortality was decreasing (41.0%, 95% CI 35.8-46.1%), and NAFLD-related burden was increasing (16.9%, 95% CI 12.1-21.7%).
Conclusion: The burden of liver cancer in India has increased. There is a male predominance and there are substantial differences by region. The shift toward metabolic risk factors and the ongoing burden from viral hepatitis indicate the need for regionally-appropriate focused prevention efforts.
Keywords: Hepatocellular carcinoma, India, Global Burden of Disease, liver cancer, epidemiology, mortality, incidence, hepatitis B, hepatitis C, NAFLD