Presentation (CTI)

OBJECTIVES: Breast cancer (BC) is commonly diagnosed worldwide, but screening and treatment guidelines differ across countries, potentially affecting outcomes. This study aimed to quantify screening, diagnosis, and treatment patterns of early BC in Germany and the US.
METHODS: Administrative claims data from Germany (AOK Plus) and the US (Forian’s “CHRONOS”) from 2017 to 2023 were used. Adult women with an incident diagnosis of early (non-metastatic) BC, continuous insurance coverage, and no other concomitant cancers were included. Demographic, clinical, screening, and treatment characteristics were summarized using means, standard deviations (SD), and ranges. Time from screening to diagnosis and diagnosis to treatment was summarized using Kaplan-Meier methods. Screening for patients aged 18-49 in Germany cannot be identified due to procedure codes that do not differentiate screening from diagnostic BC procedures.
RESULTS: A total of 11,870 patients from Germany and 59,870 from the US were included. The mean age at first diagnosis was 65.8 (SD: 15.1) years in Germany and 65.6 (SD: 12.7) in the US; the most common comorbidity was hypertension (Germany: 60.1%, US: 28%). Women in Germany aged 50-64 commonly received screening (43.8%) with a median time of 7 days from screening to diagnosis. In the US, women aged 18-49 were most commonly screened (38.1%) with a median time to diagnosis of 14 days; among those aged 50-64, 30% were screened, with a median time to diagnosis of 33 days. The most common first-line regimen in Germany was surgery + radiotherapy + endocrine therapy (25.3%); 26.7% received no treatment after 90 days, with a median time to treatment of 50 days.
CONCLUSIONS: Societal differences in screening guidelines and treatment availability across countries resulted in differences in screening and treatment patterns; future research will assess the resulting outcomes in these patients.