Waiting for Cancer Treatment: Targets, Performance and What Delay Costs

Every UK nation sets a target for how quickly people urgently referred with suspected cancer should start treatment, and in 2026 none of the four met it. In England in August 2026, 71.9% of people started their first cancer treatment within 62 days of an urgent referral, against a standard of 85% that has not been met since December 2015. A systematic review of observational studies found that, for several cancers, each four weeks of delay to treatment is linked to a higher risk of death.

Behind every waiting-time percentage is a stretch of weeks that people live through: the wait for a scan, then for the result, then for a date for surgery or the first session of treatment. Most people referred urgently will be told they do not have cancer, and for them the wait is about uncertainty. For those who do, the wait is also about whether the illness changes before treatment begins. This piece sets out what the official figures show about waits after referral, how targets differ between countries, and what the research says about what delay costs. It picks up where our study of the road from first symptom to diagnosis leaves off.

In England, more than one in four people treated for cancer after an urgent referral waited longer than 62 days to start treatment

England measures three waits after a referral. The 28-day Faster Diagnosis Standard counts how many people are told they have cancer, or that cancer has been ruled out, within four weeks of an urgent referral. The 31-day standard runs from the decision to treat to the start of that treatment, whether it is the first or a subsequent one. The 62-day standard runs from an urgent suspected cancer referral, a breast symptom referral, an urgent screening referral or a consultant upgrade to the first definitive treatment^[1].

In August 2026, the latest month published, 78.6% of people were told whether they had cancer within 28 days, 92.1% started treatment within 31 days of the decision to treat, and 71.9% of people treated started first treatment within 62 days of an urgent referral^[1]. NHS England's operational standards are 80%, 96% and 85%; the 28-day standard rose from 75% to 80% on 1 April 2026^[1]. The 62-day standard has not been met since December 2015 and the 31-day standard since December 2020^[4]. NHS England's planning guidance for 2025/26 set an interim goal of 75% on the 62-day standard by March 2026^[5], which was also missed^[4]. The National Cancer Plan for England, published in February 2026, commits the NHS to meeting all three cancer waiting time standards by March 2029^[6][4].

The direction is slowly upward. Averaged over September 2025 to August 2026, 70.2% of people started treatment within 62 days, up from 69.0% in the previous twelve months; the 28-day average rose from 76.6% to 77.3% and the 31-day average from 91.3% to 92.0%^[1]. Demand is rising at the same time: an average of 281,855 people a month were seen on the 28-day pathway over the latest twelve months, up from 275,206 a month the year before^[1]. In August 2026 alone, 27,909 referrals were counted against the 62-day standard^[1], so a gap of a few percentage points is thousands of people each month.

National averages hide large differences between hospital trusts and cancer types. Who waits longer, by income, ethnicity or place, is covered in our study of deprivation and cancer.

Each UK nation runs its own clock, and none met its 62-day target in 2026

Scotland, Wales and Northern Ireland publish their own cancer waiting times with their own definitions and targets. They are not interchangeable with England's, or with each other, and a higher percentage in one nation does not mean faster care than a lower percentage in another.

In Scotland, 4,492 eligible referrals were counted in April to June 2026 and the 62-day standard was not met by any NHS Board. The 31-day standard, from decision to treat to treatment, was much closer: 94.8% against 95%, met by 12 of the 15 boards^[2]. In Wales, 59.9% of pathways started first treatment within 62 days of cancer first being suspected in August 2026, down on July; 2,000 pathways started treatment that month, and 13,574 pathways closed with the person told they did not have cancer^[7].

Northern Ireland's figures are the starkest. In the quarter ending June 2026, 1,459 people started first treatment after an urgent GP referral and 28.4% did so within 62 days, against 29.6% the quarter before; 88.7% started within 31 days of a decision to treat, against a draft target of 98%, and 6.2% of people urgently referred with suspected breast cancer were seen within the 14-day target^[8]. Northern Ireland is moving to a new electronic records system, so these are official statistics in development and not directly comparable with earlier years^[8].

Beyond the UK, countries time different stretches of the journey

There is no common international measure of cancer waiting times. Countries choose which part of the journey to time, where to start the clock and what counts as on time, so a published figure from one country cannot be laid beside another's as if they described the same thing. The examples below show the range, not a ranking.

• New Zealand has a national Faster Cancer Treatment target: 90% of people should receive cancer management within 31 days of the decision to treat, to be reached by 2030 with yearly milestones^[9]. It times only the stretch after a treatment decision, so it is closer in shape to England's 31-day standard than to any 62-day measure.
• Canada reports a national benchmark for radiation therapy: first treatment within 28 days of the date a person is ready to be treated. In the Canadian Institute for Health Information's 2025 summary, half of people started radiation therapy within 13 days and 90% within 22 days^[10]. This times one treatment from readiness, not the whole route from referral.
• Sweden introduced standardised cancer patient pathways from 2015, each with a time target for investigation. A study of one Swedish region in 2018, covering 19,204 people who started a pathway, found that 12 of 28 pathways met the target for how many people should be included and only five met their time target^[11].

The pattern is that the parts of the journey which are easiest to measure, the weeks after a treatment decision, are where systems tend to perform best. Scotland's 31-day standard was close to target while its 62-day standard was far off, and in England the 31-day figure sits above 90% while the 62-day figure sits near 70%^[1][2]. The longest waits tend to sit earlier, in getting from referral to a diagnosis and a plan. How stage at diagnosis shapes outcomes is covered in our study of stage at diagnosis.

For several cancers, each month of delay to treatment is linked to a higher risk of death

The strongest single summary of what treatment delay costs comes from a systematic review and meta-analysis published in the BMJ in 2020. Hanna and colleagues pooled 34 studies covering 17 treatment indications in seven cancers (bladder, breast, colon, rectum, lung, cervix, and head and neck), with 1,272,681 people in total^[3]. Delay was measured from diagnosis to first treatment, or from the end of one treatment to the start of the next, and the outcome was the hazard ratio for overall survival for each four-week increase in delay. The main analysis used only studies that controlled for major prognostic factors^[3].

Longer delay was significantly associated with higher mortality for 13 of the 17 indications. For surgery the findings were consistent, with a hazard ratio of 1.06 to 1.08 for each four weeks of delay: 1.06 for colectomy for bowel cancer and 1.08 for breast cancer surgery. Estimates for systemic treatments such as chemotherapy ranged from 1.01 to 1.28. For radiotherapy, the hazard ratio was 1.09 for radical radiotherapy for head and neck cancer and 1.23 for adjuvant radiotherapy for cervical cancer, while adjuvant radiotherapy after breast-conserving surgery showed no clear effect (0.98, with a confidence interval from 0.88 to 1.09)^[3]. The authors concluded that even a four-week delay is associated with increased mortality across surgical, systemic and radiotherapy indications^[3].

A hazard ratio of 1.08 means that, over the period studied, the rate of death was about 8% higher for each additional four weeks of waiting, compared with people who started sooner. It is a relative measure: what it means in absolute terms depends on how likely death was to begin with, which varies greatly by cancer and stage.

A large US study points the same way. Using the National Cancer Database, Khorana and colleagues followed 3,672,561 people with early-stage breast, prostate, lung, bowel, kidney and pancreatic cancers diagnosed from 2004 to 2013. The median time from diagnosis to first treatment rose from 21 to 29 days over the period, and longer time to treatment was associated with worse survival for stage I and II breast, lung, kidney and pancreatic cancers and stage I bowel cancer, with hazard ratios from 1.005 to 1.030 for each extra week^[12]. Waits were longer for people treated at academic centres and those transferred between hospitals, and varied by race, education, age and other illnesses^[12].

The evidence is strong enough to act on, but uneven between cancers

Both studies are observational. People who wait longer can differ from people treated quickly in ways the data do not capture, and the bias can run both ways: someone who is very unwell may be fast-tracked, which can make short waits look worse than they are. Hanna's review tried to limit this by including only studies that adjusted for major prognostic factors, and a sensitivity analysis adding back excluded studies did not change the findings^[3]. Even so, these are associations, not proof that a particular delay caused a particular death.

The evidence is also patchy. Hanna's review found no high-validity data for five of the radiotherapy indications or for cervical cancer surgery^[3]. An earlier systematic review of 209 studies, covering the whole journey from symptoms to treatment, found that differences between studies prevented definitive conclusions; the cancers with the most evidence that shorter times go with better outcomes were breast, bowel, head and neck, testicular cancer and melanoma^[13]. Its authors judged it reasonable to assume that faster diagnosis is likely to benefit people through better survival, earlier stage and better quality of life, while noting the benefits vary between cancers^[13].

None of this tells an individual what their own wait means for them. What it does show, at population level, is that time in a queue is not neutral, and that for common cancers treated with curative intent, shorter times to treatment are associated with better survival.

What the evidence asks of us

None of what follows asks people with cancer to do anything differently.

• Meet the targets that already exist, on the dates promised. England's 62-day standard has not been met for over a decade, and its own interim target was missed in 2026^[4]. Scotland, Wales and Northern Ireland are also short of theirs^[2][7][8]. The commitment in England's National Cancer Plan to meet all three waiting time standards by March 2029^[6] needs year-by-year milestones that the public can check, as New Zealand has set for its 2030 target^[9].
• Put capacity where the longest waits are. The weeks after a decision to treat are closest to target in England and Scotland; the shortfall sits mainly between referral and treatment^[1][2]. That points to diagnostic tests, reporting and the step from diagnosis to a treatment plan.
• Treat delay as a matter of survival, not only of service quality. The authors of the BMJ review concluded that policies focused on minimising system-level delays to starting treatment could improve survival across the population^[3].
• Look at who waits longest. In the US, time to treatment varied with race, education, age and hospital transfer, and the study's authors called for work on navigation and on reducing barriers^[12]. National averages should routinely be broken down by deprivation, ethnicity, age and area.
• Publish data that can be compared. Northern Ireland's figures are official statistics in development after a records-system change^[8], and no common international definition exists.

For the wider picture of diagnosis, treatment and life after cancer, see the full cancer research library.

Language: this piece says "people with cancer" and "people living with and after cancer", and describes the illness and its treatment plainly, without combat metaphors. Clinical terms such as "stage", "incidence" and "net survival" are used in the sense the cited source defines them.

Why we're publishing this

Waiting is one of the most common experiences after an urgent referral for suspected cancer, and one of the hardest to see from the outside. We have gathered the latest official figures from each UK nation and examples from other countries, set them against each nation's own targets, and placed them beside the best evidence on what delay is linked to, so that the case for shorter waits can be made with numbers that stand up. Long waits are a gap in capacity and organisation, not something people with cancer or their families have done wrong.

How to read this data

Waiting time statistics measure how a service performs against a standard: the share of people seen or treated within a set time. They do not show how long the people outside the standard waited, and they say nothing about stage or survival on their own. Each country, and each UK nation, starts and stops the clock at different points and counts different groups, so the figures are best read against their own target and their own past, not ranked against each other. England's monthly figures are provisional and can be revised; Northern Ireland's are official statistics in development. The evidence on delay and survival comes from observational studies and is reported as hazard ratios, which compare the rate of death between groups over time; they are associations, adjusted for some but not all differences between people, and say nothing about any individual. Most of the evidence comes from high-income countries.

Use this data

Free to cite with attribution to Better Health For Everyone. Charities, campaigners and journalists are welcome to reuse these figures and charts. For the underlying figures as a spreadsheet, get in touch.

Important: This article summarises published research for general information. It is not medical advice and cannot be used to diagnose, treat or predict anything about an individual. If you have concerns about your own or someone else's health, please speak to a qualified health professional.

Sources

1. NHS England. Cancer Waiting Times, August 2026 – Provider Based – Provisional. NHS England Official Statistics, 2026. england.nhs.uk/statistics/…/Cancer-Waiting-Times-Statistical-Release-August-2026-Provider-based-Provisional.pdf
2. Public Health Scotland. Cancer waiting times: 1 April to 30 June 2026. Public Health Scotland, 2026. publichealthscotland.scot/publications/cancer-waiting-times/cancer-waiting-times-1-april-to-30-june-2026
3. Hanna TP, King WD, Thibodeau S, et al. Mortality due to cancer treatment delay: systematic review and meta-analysis. BMJ, 2020;371:m4087. europepmc.org/article/MED/33148535
4. Cancer Research UK. Cancer waiting times: latest updates and analysis. Cancer Research UK, 2026. news.cancerresearchuk.org/2026/05/15/cancer-waiting-times-latest-updates-and-analysis
5. NHS England. 2025/26 priorities and operational planning guidance. NHS England, 2025. england.nhs.uk/long-read/2025-26-priorities-and-operational-planning-guidance
6. Department of Health and Social Care. Three in four cancer patients to survive long-term under new plan (National Cancer Plan for England press release). GOV.UK, 2026. gov.uk/government/news/three-in-four-cancer-patients-to-survive-long-term-under-new-plan
7. Welsh Government. NHS activity and performance summary: August and September 2026. Welsh Government, 2026. gov.wales/nhs-activity-and-performance-summary-august-and-september-2026-html
8. Department of Health (Northern Ireland) / NISRA. Northern Ireland Cancer Waiting Times, April – June 2026. Department of Health NI, 2026. datavis.nisra.gov.uk/health/ni-cancer-waiting-times-apr-jun-26.html
9. Health New Zealand – Te Whatu Ora. Health targets. Health New Zealand, 2026. healthnz.govt.nz/about-us/what-we-do/planning-and-performance/health-targets
10. Canadian Institute for Health Information. Radiation Treatment Wait Times (indicator). CIHI, 2025. cihi.ca/en/indicators/radiation-treatment-wait-times
11. Borg S, Hörstedt AS, Carlsson T, et al. Performance of standardized cancer patient pathways in Sweden visualized using observational data and a state-transition model. Scientific Reports, 2023. europepmc.org/article/MED/37945664
12. Khorana AA, Tullio K, Elson P, et al. Time to initial cancer treatment in the United States and association with survival over time: an observational study. PLoS One, 2019. europepmc.org/article/MED/30822350
13. Neal RD, Tharmanathan P, France B, et al. Is increased time to diagnosis and treatment in symptomatic cancer associated with poorer outcomes? Systematic review. British Journal of Cancer, 2015. europepmc.org/article/MED/25734382