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Objectlve: To evaluate the effects of health insurance status on long-term cancer-specific survival of non-small cell lung cancer (NSCLC) in Beijing,China,using a population-based cancer registry data.Methods: Information on NSCLC patients diagnosed in 2008 was derived from the Beijing Cancer Registry.The medical records of 1,134 cases were sampled and re-surveyed to obtain information on potential risk factors.Poorly-insured status was defined as Uninsured and New Rural Cooperative Medical Insurance Scheme (NRCMS),while well-insured included Urban Employees Basic Medical Insurance (UEBMI) and Free Medical Care (FMC).To estimate survival outcomes,individuals were followed-up until December 31,2018.Cancer-specific survival probabilities at 5 and 10 years after diagnosis were estimated using the Kaplan-Meier method.Log-rank test was used to compare long-term survival with different characteristics.Multivariable Cox proportional hazard regression model was used to examine the relative effect of insurance status on cancer-specific mortality.Results: Well-insured NSCLC patents have longer cancer-specific survival than poorly-insured individuals[hazard ratio (HR)=0.81;95％ confidence interval (95％ CI): 0.67-0.97),even after adjusting for age,gender,cancer stage,smoking status,family history and residential area.Older age and rural residence were associated with a higher risk of cancer-specific mortality (HR=1.03;95％ CI: 1.02-1.03 and HR=1.25;95％ CI: 1.07-1.46,respectively).Smoking individuals had a 41％ higher long-term cancer-specific mortality risk than non-smoking ones (HR=1.41;95％ CI: 1.20-1.66).Conclusions: NSCLC patents with good insurance status had better survival rates than those with poor insurance.An association was significant even after 10 years.Large population-based studies are needed to validate that high reimbursement insurance status can lead to the improvement of long-term cancer prognosis in China.