Nearly half of head and neck cancer patients in England face treatment delays, landmark study finds

Nearly half of all head and neck cancer patients in England wait longer than they should for treatment, according to one of the most comprehensive analyses of cancer waiting times ever conducted (https://scienmag.com/nearly-half-of-head-and-neck-cancer-patients-in-england-face-treatment-delays-landmark-study-finds/).

The study, led by the International Centre for Recurrent Head and Neck Cancer at the Royal Marsden Hospital and the London School of Hygiene & Tropical Medicine and published in the British Journal of Cancer (https://doi.org/10.1038/s41416-026-03630-8), tracked 30,506 patients through the NHS using five linked national datasets covering cancer registration, waiting times, hospital admissions, radiotherapy and chemotherapy.

Of the patients analysed, 43% experienced treatment delay — more than 62 days between referral and the start of first treatment. Among surgery patients, 11% waited more than 90 days; for those treated primarily with radiotherapy or chemoradiation, the figure rose to 20%, one in five waiting more than three months.

The strongest predictor of delay was referral route. Patients entering through non-urgent rather than urgent suspected-cancer referral faced an adjusted odds ratio of 4.07 for long delay (95% CI 3.54–4.68) — roughly four times the risk — and non-urgent referrals accounted for 30% of the cohort. Initial assessment at non-specialist “spoke” hospitals, cancers arising outside the oropharynx, and higher socio-economic deprivation also increased the odds of delay.

The work was funded by the International Centre for Recurrent Head and Neck Cancer, received LSHTM ethics approval, and used data licensed from NHS Digital’s National Disease Registration Service.