Adherence to endocrine therapy among Chinese patients with breast cancer: current status and recommendations for improvement

Pin Gao,1 Lili You,2 Di Wu,1 Aiping Shi,1 Qing Miao,3 Ujala Rana,4 Dustin Paul Martin,3 Ye Du,1 Gang Zhao,1 Bing Han,1 Chao Zheng,5 Zhimin Fan1 1Department of Breast Surgery, First Hospital of Jilin University, Changchun, Jilin, China; 2Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; 3Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA; 4Division of Neonatology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA; 5Department of Breast Surgery, Second Hospital of Shandong University, Jinan, Shandong, China Background: Postoperative endocrine therapy is known to reduce recurrence and mortality in patients with estrogen receptor (ER)- or progestogen receptor (PR)-positive breast cancer. Correlates and determinants of compliance with endocrine therapy among Chinese patients with breast cancer are not known. The aim of this study was to elucidate the efficacy and adherence of endocrine therapy in China and suggest effective improvements on the adherence. Patients and methods: We analyzed the survival of 1,110 patients eligible for endocrine therapy and adherence of 699 patients to endocrine therapy. Kaplan–Meier curves, log-rank tests and Cox proportional hazard models were used to evaluate survival, and logistic regression models were used to assess variables associated with treatment adherence. Results: Long-term endocrine therapy was associated with lower recurrence rate (HR 0.72; 95% CI 0.56–0.93; p=0.013). Adherence to endocrine therapy was only 63.1%. Sociodemographic characteristics of patients, clinical- and medication-related characteristics and patients’ attitudes were associated with adherence to endocrine therapy. Conclusion: Adherence to endocrine therapy in Chinese patients with ER+/PR+ breast cancer was