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William J. Gradishar, MD, FACP, FASCO


Disparities in Early Breast Cancer Treatment in China Versus the United States

By: Chris Schimpf, BS
Posted: Thursday, August 24, 2023

JAMA Network Open has published research examining trends in disparities in early breast cancer treatment between patients in China and patients in the United States. In a large multicenter, cross-sectional study, Jianbin Li, MD, of the Fifth Medical Center of Chinese People’s Liberation Army General Hospital and the Institute of Biotechnology, Academy of Military Medical Sciences, Beijing, and colleagues observed disparities in patient ages, cancer stages and subtypes, and therapies used among women with breast cancer in the two countries between 2011 and 2021. Although these disparities appeared to be significant, the study’s findings suggest they narrowed gradually over the course of the decade. The investigators believe that further population studies are warranted.

A total of 57,720 patients diagnosed with stage I to III breast cancer between January 2011 and December 2021 were included in the study, drawn from two separate databases. Data from hospitals in 13 Chinese provinces came from the Chinese Society of Clinical Oncology Breast Cancer (n = 45,970) , and data from more than 280 community oncology clinics in the United States came from Flatiron Health (n = 11,750).

The median patient age at diagnosis in China was 47, versus 64 in the United States. The proportions of stage I, stage II, and stage III cancer were 31.8% versus 54.6%, 44.1% versus 33.6%, and 24.1% versus 11.9%, respectively. The proportion of hormone receptor–positive cancer in China was 69.8% versus 87.5% in the United States. For patients with ERBB2-positive cancer, the proportion treated with trastuzumab in China increased significantly over time, with a mean annual percent change of 22.1% (confidence interval [CI] = 95%; P < .001). Between 2017 and 2021, 68.5% of those patients were treated with trastuzumab in China, versus 62.5% in the United States (P < .001). The investigators posited that this may be suggestive of differential access to targeted ERBB2 therapy.

Disclosure: For full disclosures of the study authors, visit

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