When care happens is as important as what happens: the case for timed targets in lung cancer
A new policy brief from the Lung Cancer Policy Network argues that setting clear, measurable deadlines across the lung cancer pathway could reduce delays and save lives. Here is why it speaks directly to our work, and to people living with lung cancer across Europe.
Lung cancer is the leading cause of cancer death worldwide. In 2022, around 2.5 million people were diagnosed and 1.8 million died. By 2050, those figures are projected to reach 4.6 million new cases and almost 3.6 million deaths. Behind those numbers sits a problem that is often overlooked: not only whether people receive good care, but how quickly they receive it. Delays happen at every stage, from recognising symptoms and acting on an incidental finding, to confirming a diagnosis and starting treatment. Each delay can narrow the treatment options available to someone and reduce their chance of survival.
The Lung Cancer Policy Network, of which Lung Cancer Europe is a member, has set out a clear response in its new policy brief on timed targets for lung cancer care.
What timed targets are, and why they help
The central argument is straightforward. Health systems should set timed targets: specific, measurable deadlines for each step of the pathway, written into clinical guidelines and national cancer plans, with clear accountability when they are missed. The brief does not prescribe the exact numbers, which need to reflect each country's resources and structures. It makes the case that the targets should exist at all, and that too often they do not.
Where they do exist, they can work. In one Canadian clinic, a redesigned triage process cut the average wait for a diagnosis from 38 days to 23, and for a PET scan from 38.5 days to under 16. England's National Optimal Lung Cancer Pathway sets equally clear expectations: a CT scan within 72 hours of referral, a full work-up within 14 days, and first treatment within 49 days of referral.
The difficulty is that targets are frequently missed, and in much of Europe they are not set in the first place. In England, the 62-day target from referral to treatment has not been met nationally for over a decade. Many European lung cancer guidelines set no time frame at all for diagnostic referral, and the 2023 European Respiratory Society guideline stresses the importance of reducing delays but stops short of recommending specific targets. That gap is a policy opening, not only a technical one.
Delays are not felt equally
Waiting times fall hardest on the people who can least absorb them. The brief shows that where someone lives, how much they earn and their sex can all shape how long they wait. In Hungary, women have been found to wait longer than men for lung cancer care. In Serbia, now the country's leading cause of cancer incidence and mortality, molecular testing is available at only three certified centres nationwide, and many people are pushed to pay out of pocket because the public system cannot keep pace. Two of Serbia's four university pulmonology centres have begun introducing timed targets, a foundation the brief argues should be extended across the country.
Reducing these inequalities across Europe is one of our core priorities. Timed targets, applied fairly and monitored with good data, are a practical tool for doing exactly that.
Timing decides who benefits from innovation
Timeliness also determines whether people can benefit from progress at all. Modern lung cancer treatment often depends on biomarker testing to match a person to a targeted therapy, and when that testing is slow, the window can close. The brief notes that only 60% of genomic tests in England are delivered on time. Delays can leave people waiting to start treatment and, in some cases, affect access to targeted therapies where funding rules restrict their use to the first-line setting.
Guaranteeing timely and equitable access to biomarker testing is one of our key asks, and it is written into our Charter as a standard every person affected by lung cancer should expect. A treatment that exists but arrives too late helps no one.
The same logic applies to specialist care. Coordinated review by a multidisciplinary team is central to timely, accurate treatment decisions, yet it is still far from universal. Making multidisciplinary review a standard part of every new diagnosis is both a Charter commitment and one of the surest ways to keep people moving through the pathway without avoidable delay.
The framework already exists
The brief's message aligns closely with our own: faster care is not a luxury, it is a measure of how well a health system works. Europe already has the scaffolding to act. Europe's Beating Cancer Plan set out cancer targets with clear timelines, and the WHO resolution on lung health gives further backing. Turning that ambition into timed, measurable and accountable targets for lung cancer would mean earlier diagnoses, more treatment options, and fewer people deteriorating while they wait.
For the millions of people who will face lung cancer in the years ahead, when their care happens will help decide how many of them survive it.
The full policy brief is available from the Lung Cancer Policy Network.
Further reading from Lung Cancer Europe
Faster biomarker testing for lung cancer: the FAST-NGS pilot in GreeceBiomarker testing is moving faster than ever. Is Europe keeping up?Why biomarker testing should be routine in all NSCLCAccess to Treatment Atlas: compare lung cancer treatment access across EuropeEngland catches up on cemiplimab for advanced lung cancer