OBJECTIVES: Owing to the large smoking population and air pollution, the incidence of lung cancer is continuously increasing in China. It has adapted the National Comprehensive Cancer Network (NCCN) clinical practice guidelines in lung cancer for disease management. However, studies have suggested that there are large disparities in the treatment of lung cancer in China. The objective of this research is to identify the factors that contribute to treatment disparity in China. METHODS: A literature search was conducted to retrieve NCCN and other clinical practice guidelines describing management of lung cancer patients in China. The guidelines were reviewed to assess the treatment disparities for lung cancer management in China. RESULTS: The NCCN China edition comprises of extensive expertise of more than 100 Chinese cancer specialists and NCCN panel experts. The country adaptation version of China has considered metabolic differences in populations, accessibility of technology, and regulatory status of health technologies in China. Treatment disparities for lung cancer exist in terms of disease staging, chemotherapy for advanced disease, and targeted therapies for advanced stage lung cancer. Further, patients from developed cities have access to more standard treatment compared with those from other regions. A study reported that 20.6% of stage I patients were over-treated and 20.1% of stage II patients were under-treated. These treatment disparities are severe as the adoption of evidence-based guideline recommended treatments are probably the best and the only way to significantly improve the treatment of lung cancer. Treatment disparities could be attributed to high treatment costs, insufficient insurance coverage, lack of oncologists and lack of awareness to advance therapies.  CONCLUSIONS: Increased collaboration is required among different areas in China to ensure that all lung cancer patients, regardless of socioeconomic and geographic barriers, are treated with and reimbursed for standardize treatment and palliative care.