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Background: Surgery or radiation therapy (RT) remains the definitive treatment for early-stage (Stage I/II) non-small cell lung cancer (NSCLC). Early-stage NSCLC should be treated appropriately since survival decreases progressively with advanced stages. Our study aims to identify the factors associated with receiving no definitive therapy among US patients. Methods: Patients ≥ 18 years and diagnosed with stage I/II NSCLC from 2004-2011 in Surveillance, Epidemiology and End Results Program (SEER) were identified. Definitive therapy was defined as receiving surgery and/or RT. Socio-economic characteristics (income, educational status and residence type) were collected at county-level. Predictors for no definitive therapy were estimated with a multivariable logistic regression model. Results: A total of 32,401 patients were identified. 4,997 patients (15%) had no definitive therapy and among …