Timely treatment is crucial for patients with cancer, affecting both their experience and outcomes. This study examined events that shorten or extend cancer pathways. A cohort of breast, lower gastrointestinal, lung, and prostate cancers diagnosed between 2015 and 2016 in England were identified using cancer registration data. This was linked to Hospital Episode Statistic data, Cancer Waiting Times data, and specialized treatment data sets to highlight key events and dates in the pathways of 236 205 patients. Our fixed-effects panel regression included straight-to-test first appointments, multiple tests on the same day, number of multidisciplinary team meetings, appointment cancellations, trust fixed effects, and patient factors, including sex, ethnicity, index of multiple deprivations, age, comorbidities, stage, and route to diagnosis. Patients with straight-to-test, multiple tests on the same day, and who were discussed in a single multidisciplinary team meeting waited a shorter time for treatment (-5, -4, and -7 days, respectively). Cancelled appointments and attending multiple providers were associated with longer pathways (+11 and +9 days). Our findings highlight specific areas in which redesigning cancer pathways and transfers between hospitals could potentially lead to less waiting time for treatment, and suggest that policies aimed at reducing cancellations, by patients or hospitals, have the potential to improve waiting times. • A PubMed search of the existing evidence suggests that delays in cancer pathways can be attributed to certain factors, including a greater number of diagnostic tests, a larger number of appointments on the pathway, and diagnostic assessments and treatment at different locations, and were shown to increase overall waiting times for treatment. In contrast, patients who underwent a diagnostic test at their first appointment had shorter overall pathways. • This study considered a range of pathway characteristics otherwise unexplored in the existing evidence, such as the number of multidisciplinary team meetings and cancelled appointments. Information was collected from the National Cancer Registration and Analysis Service data set on all cancer pathways in England and different types of healthcare events along these pathways, yielding a large sample size of roughly 236 000 cancer pathways. Although previous studies focused on 1 to 2 tumor types, this study evaluated 4 different tumor sites simultaneously, allowing for direct comparisons among these sites and considered the average values to provide more generalizable results. • Our findings and related literature encourage the use of "straight to test" approaches and planning multiple tests on the same date, where possible, to deliver faster treatment. Moreover, in cases involving multiple multidisciplinary team meetings or providers, a better understanding of the impact of these factors on the time to treatment can encourage managers and clinicians to redesign treatment protocols. Finally, the findings suggest that missed and canceled appointments should be avoided or rescheduled promptly to avoid delays. This evidence may encourage providers to redesign their cancer treatment pathways to improve patients' experience and improve time to treatment. Future research could consider the cost implications of such pathway changes to assess the financial feasibility for providers. [ABSTRACT FROM AUTHOR]