A retrospective study was conducted using 1993–2021 WV Cancer Registry data to identify persons diagnosed with NSCLC who received treatment. Time to treatment from diagnosis was determined and dichotomized as early treatment (<35 days) vs delayed treatment (≥35 days). Descriptive statistics, comparative and survival analyses (with univariate and multivariate Cox regression were used to address study objectives.

Of 10,463 participants, the majority were male (58.1 %), married or partnered (59.9 %), non-Hispanic white (97.5 %). 61 % received early treatment. 45 %, 38 %, and 16 % received systemic therapy, surgery, and radiation, respectively.

Baseline characteristics significantly associated with treatment receipt included being male (HR=1.08, 95 % CI=1.04–1.13), cancer stage (HR range=1.19–2.38, being Black and receiving surgery (0.43, 0.30–0.62), radiation (0.48, 0.33–0.68), or systemic therapy (0.33,0.23–0.47) (compared to other treatment). Baseline characteristics significantly associated with death include rurality (HR=1.09, 95 % CI=1.00–1.18), age (HR=1.01, 1.01–1.02), male gender (HR=1.21 (1.16–1.26), being married (0.92, 0.88–0.96), comorbidity (1.07, 1.05–1.09), cancer stage (HR range=1.58–4.79), and receiving surgery (0.16, 0.11–0.22), radiation (0.34, 0.24–0.49), or systemic therapy (0.17, 0.12–0.24) (compared to other treatment).

In WV, most patients with NSCLC who receive treatment are treated early. Sociodemographic and clinical factors such as being male, cancer stage and type of treatment predicted time to treatment receipt and were likewise associated with overall survival. Cancer stage represents a modifiable factor that may be responsive to interventions aimed at improving lung cancer outcomes through early diagnosis.