Only half of people with cancer are diagnosed on time following urgent NHS referral, and for some cancers this drops to less than a third, analysis shows.
The NHS target for England is to rule cancer in or out within 28 days of an urgent referral, but new figures show people with cancer are waiting far longer for diagnosis than those who have the disease ruled out.
The Cancer Research UK report found that between October 2021 and June 2024, 53.8% of people who had cancer were diagnosed within 28 days compared with 71.7% for those who had cancer ruled out.
For all patients on the pathway combined, 70.6% received an outcome within 28 days.
The study identified that for people being diagnosed with cancer, things have actually been getting worse over time.
In the last three months of 2021, 57.3% of diagnoses were given within 28 days, but this fell to 52.3% by the middle of 2024.
There was also large variation by cancer type, with 83.2% of testicular cancer referrals leading to diagnosis within 28 days, but for urological cancers such as prostate and kidney, less than a third (29%) of referrals resulted in timely diagnosis.
This was followed by sarcomas (31.4%) and head and neck cancers (34.6%).
There have been recent improvements in NHS performance against the target, with 76.8% of urgent patients in England diagnosed or having cancer ruled out within 28 days in June, up from 74.8% in May, against a 75% target.
The Government has set a target of March 2026 for this figure to reach 80%.
Delaying cancer diagnosis can lead to worse outcomes for patients, such as fewer options for treatment and earlier death.
Around 6% of all urgent suspected cancer referrals result in a cancer diagnosis.
The new report has been published by Cancer Research UK in partnership with the National Disease Registration Service, which is part of NHS England.
Cancer Research UK chief executive Michelle Mitchell said: “Waiting for a cancer diagnosis can make every single day feel like forever.
“It’s promising that more people are having cancer ruled out on time, helping to put their minds at ease.
“However, it’s unacceptable that only half of people who have cancer are being diagnosed within the target timeframe.
“The UK Government needs to act.
“Its upcoming national cancer plan for England must include a new commitment to diagnose cancers earlier, and a pledge to meet all cancer wait time targets by the end of this Parliament, including the increased faster diagnostic standard target.
“This will require investment in specialist staff and equipment, coupled with reform. Without these actions, things could continue to get worse instead of better.”
NHS England is now publishing separate figures on people having cancer ruled in or out – something Cancer Research UK says will help health leaders understand what is holding cancer diagnoses back.
The report also found that waits for a diagnosis for the worst performing cancer types are much longer than 28 days.
Over half of people diagnosed after a urological cancer referral (54.6%) waited more than 42 days for a diagnosis.
Cancer Research UK said this variation is due to a number of factors, including that some cancer types are more complicated to diagnose and require more specialist staff and equipment.
It comes as the Royal College of Radiologists (RCR) and the Society of Radiographers said patients face unequal access to innovative cancer treatments due to the way they are commissioned on the NHS and funded.
It said NHS trusts are currently not incentivised to offer world-class cancer treatments such as cutting-edge radiotherapy and new drugs.
One example is Stereotactic Ablative Body Radiotherapy (SABR), a way of targeting radiotherapy to a tumour from many different directions.
This means patients require fewer sessions, spend less time in hospital and experience fewer side-effects.
The RCR said the current funding model requires a “cumbersome” application process which can delay NHS trusts adopting SABR, while the funding they are given can be less than cost of delivery, which puts them off adopting it.
Dr Nicky Thorp, vice-president for clinical oncology at the RCR, said: “Red tape is preventing equal access to innovative types of radiotherapy and new drugs that can transform lives.
“The upcoming NHS cancer plan presents a fantastic opportunity to commit to reconsider how these are commissioned and funded.
“This would shift the dial by encouraging trusts to embrace innovation and helping more patients benefit from the latest treatments.”
