The annual survey by the American Chamber of Commerce (AmCham) in China showed 51% of respondents were concerned about a future deterioration in the U.S.-China relationship.

It was released just days after U.S. President Donald Trump took office for a second term with the threat of increasing trade tariffs on Chinese imports.

"A stable and constructive relationship, grounded in economic and trade ties, is critical not only for the prosperity of our two nations but also for global economic stability," said AmCham China Chair Alvin Liu.

Geopolitical tensions, policy uncertainties, and trade disputes were major concerns of U.S. businesses in China, AmCham China said.

The survey of 368 AmCham China member companies was completed between October and November last year, partly after Trump won the presidential election on Nov. 5.

His previous term as president was marked by a U.S.-China trade war and general decline in diplomatic goodwill between the two countries that did not markedly improve during President Joe Biden's tenure.

On Tuesday, Trump said his administration was discussing a 10% punitive duty on Chinese imports that could be imposed from Feb. 1 in relation to China's part in the global supply chain of fentanyl.

Almost half of the respondents still rank China as a top-three global investment priority, around the same level as last year. However, the proportion of companies that no longer list China as a preferred investment destination has more than doubled to 21% compared with pre-pandemic levels and rose three percentage points from last year's survey.

Also around the same level as last year are the proportion of firms reporting unfair treatment in China compared with local firms - around a third of businesses - particularly in relation to market access and public procurement.