['To identify and compare treatment and system factors associated with survival in early-stage glottic cancer.', 'Retrospective study of cases in the Commission on Cancer National Cancer Database.', 'Adult patients with early glottic cancer (stage I or II) diagnosed between January 1, 2004, and December 31, 2012, were included. Demographic, tumor, and survival variables were included in the analyses. Multivariate Cox regressions as well as univariate Kaplan-Meier analyses were conducted.', 'In total, 5,627 patients were included in the study. Treatment factors associated with improved survival included larynx-preserving surgery alone (hazard ratio [HR] 0.740; P = 0.001) and larynx-preserving surgery with radiation (HR 0.837; P = 0.010) when compared to radiotherapy alone. System factors associated with worse survival included intermediate- (HR 1.123; P = 0.047) or low- (HR 1.458; P = 0.017) volume centers; Medicaid (HR 1.882; P < 0.001), Medicare (HR 1.532; P < 0.001), or other government insurance (HR 2.041; P < 0.001); and delay between diagnosis and treatment greater than 100 days (HR 1.605; P = 0.006).'] Are treatment delay and facility case volume associated with survival in early-stage glottic cancer?