Reduced delays in diagnostic pathways for non-small cell lung cancer after local and National initiatives

•Local and national initiatives reduce total time to treatment (TTT).•The longer the TTT, the larger the reduction.•Total time to treatment reduced with 3 weeks (33%) in curative treatments.•Delaying factors: low stage, number of diagnostic procedures, use of PET-CT. Patients with non-small cell lung cancer (NSCLC) may experience progression and stage shift due to delays in a complex and time-consuming diagnostic work-up. We have analyzed the impact of both a local and national intervention on total time to treatment (TTT). All patients diagnosed with NSCLC at a Norwegian county hospital from 2007 to 2016 were reviewed. Logistic bottlenecks and delays were identified (2007–12) resulting in implementation of a local initiative with new diagnostic algorithm introduced by the beginning of 2013. In 2015, national diagnostic cancer pathways were implemented. TTT defined as time from received referral from the primary physician to start of treatment was compared in the three diagnostic time periods; baseline (2007–12), local (2013–14) and national (2015–16). A total of 780 patients were included. Among patients treated with curative intent the median TTT decreased by 21 days, from 64 to 43 days (p