The need for a rapid and comprehensive adoption of the revised European standard population in cancer incidence comparisons

As cancer incidence varies according to age, it is important to rule out differences in age structures in any comparison. A common way of adjusting for these differences is using direct age standardization, which applies age-specific weights from a standard population. Eurostat has recently introduced a revised European standard population (RESP). The effect of using the new standard, in comparison with that introduced in 1976 [European standard population (ESP)], is evaluated. Cancer incidence data for prostate and testis cancer for Denmark, Finland, Sweden, Norway, and Iceland from the NORDCAN web site, and for Ireland and Italy-Genoa from Cancer Incidence in five Continents-X, were analyzed. Incidence rates were directly age standardized using ESP and RESP. The RESP conferred greater weight to adults and the elderly than the ESP. For prostate cancer, age-standardized rates computed with RESP are consistently higher by between 50 and 60% than those computed with ESP. However, the use of RESP, instead of ESP, has little impact on the pattern of time trends, the relative ranking of countries, the values of relative risks, or the percentage differences between age-standardized rates. For testis cancer, RESP and ESP provide very similar results because this cancer is more common in young men. Both ESP and RESP are in circulation. It is, therefore, important that European cancer registries reach consensus on a single standard to use to avoid erroneous comparisons of data computed with different standards. Given that Eurostat recently introduced RESP and is using this standard for data collected from the European Union Member States, it would make sense to rally behind RESP.