Abstract
BACKGROUND: Access to innovation in oncology is commonly examined from technical, organisational, or economic perspectives, yet less is known about how patients experience access along cancer care pathways. This study synthesised qualitative evidence on adult patients' experiences of accessing innovation. METHODS: We conducted a qualitative systematic review between Sept 1 and Oct 24, 2025, using the Joanna Briggs Institute meta-aggregation approach. MEDLINE, PsycINFO, Cairn.info, and OpenEdition were searched. Eligible studies reported adult patients' experiences of access to innovation in oncology. Findings were appraised, grouped by similarity in meaning, and aggregated into synthesised findings. Confidence was assessed using the ConQual approach. This review is registered with PROSPERO, CRD420251046315. FINDINGS: 20 studies involving 306 patients were included. We identified 209 findings, grouped into 13 categories and four synthesised findings. Access to innovation was described as depending on accessible information, continuity of care, conditions supporting self-management, and the availability of spaces not centred on disease. INTERPRETATION: Access to innovation extends beyond availability or eligibility. It emerges as a dynamic process shaped by time, care relationships, personal resources, and organisational context. Aligning innovation with patients' lived experiences may support more equitable access. FUNDING: The Integrated Cancer Research Centre (SIRIC) InsiTu: Insights into Cancer: From Inflammation to Tumour.