Disclaimers: The contents of this publication are the sole responsibility of the authors and do not necessarily reflect the views, opinions or policies of the USUHS, HJF, the DoD or the Departments of the Army, Navy, or Air Force. Mention of trade names, commercial products, or organizations does not imply endorsement by the U.S. Government. Introduction: Non-small-cell lung cancer (NSCLC) comprises of 85% - 90% of lung cancer, the leading cause of cancer-related deaths in the US with Black patients had higher death rate than White patients. Barriers to health care access plays an important role in the racial disparity. The DoD Military Health System (MHS) provides equal access for beneficiaries, presumably reducing barriers to health care and thus racial disparity in cancer survival. However, there have been no studies comparing the racial groups using the large DoD cancer registry data and the large national cancer registry data, respectively. We used the system-wide data from the DoD’s Central Cancer Registry (CCR) and the national Surveillance, Epidemiology and End Results (SEER) program to assess racial differences in survival among NSCLC patients in each system. Methods: The DoD CCR registry collects demographics, cancer diagnosis, tumor characteristics, treatments, follow-up, and vital status of MHS beneficiaries with cancer. SEER is a population-based national cancer registry program with populations resided within the served areas representing characteristics of the US general population. We conducted a retrospective study comparing survival of NSCLC patients from CCR and SEER by race, respectively. Results: Kaplan-Meier survival curves showed no survival difference between Black and White patients in CCR (Log-rank p=0.204), while in SEER, Black patients showed significantly worse survival than White patients (Log-rank p<0.0001). In Cox regression models adjusting for confounders, Black patients and White patients in CCR had similar survival (hazard ratio (HR) =0.95, 95% confidence interval (95% CI)= 0.87-1.04). In contrast, Black patients in SEER showed poorer survival than White patients (HR=1.01, 95% CI=1.00-1.02). When stratified by tumor stage, the results for early-stage patients were similar to the overall comparison. However, among late-stage patients, CCR Black patients tended to have better survival than White patients (HR=0.89, 95% CI=0.80-0.98), while no survival difference was observed among late-stage patients in SEER (HR=1.00, 95% CI=0.99-1.01). Conclusions: Improved access to health care in MHS could reduce the racial disparity in survival of NSCLC patients.