Almost all commentators accept that the United Kingdom poor performance in cancer is genuine. (Coleman et al, 2011) Of more interest is why this should be so; in particular, how much of the problem rests in diagnostic delay? The evidence for diagnostic delay includes poor 1-year mortality (Morris et al, 2011), a high number of general practice consultations before diagnosis (Lyratzopoulos et al, 2012), and the inverse relationship between the strength of primary care and cancer survival (Vedsted and Olesen, 2011). It is also important to unpick the components of diagnostic delay, as each has different solutions. Delay in seeking medical care can be combated by awareness campaigns; delays in primary care could be tackled by education or enhanced provision of investigations; hospital delays are generally countered by improved organisation of services. Many of these have been tried, with some progress (Health, 2011).