Impact of New Standardized Population for Estimating Cancer Incidence in Indian Context- an Analysis from National Cancer Registry Programme (NCRP).

Sathishkumar K,Vaitheeswaran K,Sathya N,Prashant Mathur,Stephen S

doi:10.31557/apjcp.2020.21.2.371

Abstract

Objective:Standardization adjusts for variations in population age-distribution and provides a summary measure for the comparison of populations and comparisons of time-trends in population. Globally, several standard population were used by many countries for comparison of rates. Segi World Standard Population (WSP) is suitable for international comparison. However, national standard population would be more appropriate for Intra-national comparison as the standard should be similar to the population of interest. This study aimed to develop Indian Standard Population (ISP) for estimating Age Adjusted Rate (AAR) and, to understand the outcome on the cancer incidence rate using ISP in Population Based Cancer Registries (PBCRs). Methods:The Indian Standard Population was estimated based on the average age structure of three Censuses (1991,2001 and 2011). Age Adjusted Rate has been estimated using two standard populations of WSP and ISP for magnitude of change and comparison between 15 PBCRs in India. Results:The implementation of ISP led to overall 20% reduction in AAR for all sites of cancers in both sexes and minor relative changes in the ranking among PBCRs. Time trends in cancer incidence rate showed same temporal pattern curve using both ISP and WSP, AARs. Conclusion:The ISP would be more representative of the age-structure of Indian registries population and this would give more realistic comparison across the different PBCRs in India.

Highlights

Comparing incidence and mortality rates in two or more different regions/areas is vital for the assessment of health status of the community (Naing, 2000)
This study aimed to develop Indian Standard Population (ISP) for estimating Age Adjusted Rate (AAR) and, to understand the outcome on the cancer incidence rate using ISP in Population Based Cancer Registries (PBCRs)
Segi standard population (Segi, 1960) age structure is not representative of Indian population structure, an attempt was made in this study to use Indian Standard Population (ISP) for estimating Age Standardised Rate (ASR)/Age Adjusted Rate (AAR) using age structure of Indian population and, to understand the outcome on the incidence rate of cancer using Indian standard population in Population Based Cancer Registries along with Segi World Standard Population (WSP) (Segi, 1960)

Summary

Introduction

Comparing incidence and mortality rates in two or more different regions/areas is vital for the assessment of health status of the community (Naing, 2000). The world standard population was previously used by many studies for comparing cancer incidence rates in different regions (NCDIR, 2013; Torre et al, 2015). This was originally proposed in 1960 as the pooled population of 46 countries and, thereafter, revised in 1966.The new standard population in the year 2000 was constructed by World Health Organisation (WHO) as the average of projected world population age structure during the years 2000–2025 (Segi, 1960; Doll et al, 1966; Ahmad et al, 2000).The US has replaced the existing 1940 standard population with new standard of US 2000 population (Anderson and Rosenberg, 1998). Segi standard population (Segi, 1960) age structure is not representative of Indian population structure, an attempt was made in this study to use Indian Standard Population (ISP) for estimating Age Standardised Rate (ASR)/Age Adjusted Rate (AAR) using age structure of Indian population and, to understand the outcome on the incidence rate of cancer using Indian standard population in Population Based Cancer Registries along with Segi WSP (Segi, 1960)

Materials and Methods

Results

Discussion