{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:56:04Z","timestamp":1792166164873,"version":"4.4.0"},"reference-count":53,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The COVID-19 pandemic has significantly impacted cancer care services in the United Kingdom (UK), potentially exacerbating pre-existing health inequalities. While emerging studies have documented service disruptions, a comprehensive synthesis of how these disruptions have widened disparities remains absent. This systematic review examines the extent to which the pandemic disrupted the cancer care pathway and intensified existing disparities across the UK, identifying key sociodemographic and geographical factors influencing access to services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of PubMed, Scopus, and CINAHL was conducted for studies published between January 2020 and October 2024. Eligible studies included observational and empirical research examining disparities in cancer screening, diagnosis, treatment, and outcomes during the COVID-19 pandemic, as well as the corresponding mitigation strategies. Data extraction followed a structured approach using a custom-developed extraction form designed for this review. Study quality was appraised using a bespoke scoring system, classifying studies as high, moderate, or low importance. Narrative synthesis, following the framework outlined by Popay et al., was then employed to identify key themes and explore relationships between findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>30 out of 457 studies met the inclusion criteria. The review found that socioeconomic status (SES) emerged as the most significant determinant, with individuals from deprived areas experiencing greater barriers to screening, urgent referrals, and treatment access, leading to poorer patient outcomes. Ethnic minorities, particularly Black patients, faced disproportionate reductions in hospital admissions and cancer screening participation. Age-related disparities were also evident, as older adults maintained higher screening rates but faced greater COVID-19 risks, while younger adults from lower-income backgrounds encountered delays in diagnosis and treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The review highlights that the COVID-19 pandemic has exacerbated existing inequalities in UK cancer care, with SES, ethnicity, and age emerging as key determinants. Targeted interventions are essential, including the establishment of COVID-free \u201ccold sites\u201d, deployment of mobile screening units, and culturally tailored outreach programmes for ethnic minority communities. Strengthening regional healthcare capacity and conducting longitudinal assessments will be crucial in addressing disparities and ensuring equitable cancer care. Future research should focus on the long-term consequences of these disruptions on cancer outcomes and healthcare resilience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>The protocol for this systematic review was registered on PROSPERO under the ID CRD42024602280.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12913-026-14313-8","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T17:00:43Z","timestamp":1774544443000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["COVID-19\u2019s disruptions to cancer care pathways and widening of health inequalities in the UK: a systematic review"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1765-4831","authenticated-orcid":false,"given":"Cheuk Him Michael","family":"Lam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7521-8289","authenticated-orcid":false,"given":"Kar Chun","family":"Cheung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3135-0364","authenticated-orcid":false,"given":"Thomas","family":"Mason","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4314-6523","authenticated-orcid":false,"given":"Bruce","family":"Hollingsworth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"issue":"8","key":"14313_CR1","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.1016\/S1470-2045(20)30392-2","volume":"21","author":"A Sud","year":"2020","unstructured":"Sud A, Torr B, Jones ME, Broggio J, Scott S, Loveday C, et al. Effect of delays in the 2-week-wait cancer referral pathway during the COVID-19 pandemic on cancer survival in the UK: a modelling study. Lancet Oncol. 2020;21(8):1035\u201344.","journal-title":"Lancet Oncol"},{"key":"14313_CR2","doi-asserted-by":"publisher","first-page":"100316","DOI":"10.1016\/j.jcpo.2021.100316","volume":"31","author":"L Fox","year":"2022","unstructured":"Fox L, Monroy-Iglesias MJ, Aggarwal A, Haire K, Purushotham A, Spicer J, et al. Association between COVID-19 burden and delays to diagnosis and treatment of cancer patients in England. J Cancer Policy. 2022;31:100316.","journal-title":"J Cancer Policy"},{"key":"14313_CR3","unstructured":"Stephens K. Every month delayed in cancer treatment can raise risk of death by around 10%. AXIS Imaging News. 2020."},{"issue":"8","key":"14313_CR4","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1016\/S1470-2045(20)30388-0","volume":"21","author":"C Maringe","year":"2020","unstructured":"Maringe C, Spicer J, Morris M, Purushotham A, Nolte E, Sullivan R, et al. The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national, population-based, modelling study. Lancet Oncol. 2020;21(8):1023\u201334.","journal-title":"Lancet Oncol"},{"key":"14313_CR5","doi-asserted-by":"crossref","unstructured":"Whitehead M. The concepts and principles of equity and health. Int J Health Serv. 1992 July;22(3):429\u201345.","DOI":"10.2190\/986L-LHQ6-2VTE-YRRN"},{"issue":"2","key":"14313_CR6","doi-asserted-by":"publisher","first-page":"e057244","DOI":"10.1136\/bmjopen-2021-057244","volume":"12","author":"T Mason","year":"2022","unstructured":"Mason T, Whittaker W, Dumville JC, Bower P. Variation in appropriate diabetes care and treatment targets in urban and rural areas in England: an observational study of the \u2018rule of halves\u2019. BMJ Open. 2022;12(2):e057244.","journal-title":"BMJ Open"},{"issue":"9","key":"14313_CR7","doi-asserted-by":"publisher","first-page":"e0272202","DOI":"10.1371\/journal.pone.0272202","volume":"17","author":"NW Payne","year":"2022","unstructured":"Payne NW, Brown KF, Delon C, Kotrotsios Y, Soerjomataram I, Shelton J. Socio-economic deprivation and cancer incidence in England: Quantifying the role of smoking. PLoS ONE. 2022;17(9):e0272202.","journal-title":"PLoS ONE"},{"key":"14313_CR8","doi-asserted-by":"crossref","unstructured":"Keidan N, Aujayeb A. Small cell lung cancer and pleural effusion: an analysis from a district general hospital. Pulm Ther. 2023 Sept;9(3):359\u201365.","DOI":"10.1007\/s41030-023-00228-w"},{"key":"14313_CR9","doi-asserted-by":"crossref","unstructured":"Taylor-Phillips S, O\u2019Sullivan E, Kearins O, Parsons H, Clarke A. The effects of a UK review of breast cancer screening on uptake: an observational before\/after study. J Med Screen. 2013 June;20(2):86\u201390.","DOI":"10.1177\/0969141313497198"},{"issue":"6","key":"14313_CR10","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1038\/s41416-021-01472-0","volume":"125","author":"AC Hamilton","year":"2021","unstructured":"Hamilton AC, Donnelly DW, Loughrey MB, Turkington RC, Fox C, Fitzpatrick D, et al. Inequalities in the decline and recovery of pathological cancer diagnoses during the first six months of the COVID-19 pandemic: a population-based study. Br J Cancer. 2021;125(6):798\u2013805.","journal-title":"Br J Cancer"},{"issue":"7","key":"14313_CR11","doi-asserted-by":"publisher","first-page":"1514","DOI":"10.3390\/cancers13071514","volume":"13","author":"SF Lee","year":"2021","unstructured":"Lee SF, Nik\u0161i\u0107 M, Rachet B, Sanchez MJ, Luque-Fernandez MA. Socioeconomic inequalities and ethnicity are associated with a positive COVID-19 test among cancer patients in the UK Biobank cohort. Cancers. 2021;13(7):1514.","journal-title":"Cancers"},{"issue":"5","key":"14313_CR12","doi-asserted-by":"publisher","first-page":"836","DOI":"10.1038\/sj.bjc.6603622","volume":"96","author":"A Downing","year":"2007","unstructured":"Downing A, Prakash K, Gilthorpe MS, Mikeljevic JS, Forman D. Socioeconomic background in relation to stage at diagnosis, treatment and survival in women with breast cancer. Br J Cancer. 2007;96(5):836\u201340.","journal-title":"Br J Cancer"},{"issue":"2","key":"14313_CR13","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1016\/j.ejca.2007.07.028","volume":"44","author":"AP Jones","year":"2008","unstructured":"Jones AP, Haynes R, Sauerzapf V, Crawford SM, Zhao H, Forman D. Travel times to health care and survival from cancers in Northern England. Eur J Cancer. 2008;44(2):269\u201374.","journal-title":"Eur J Cancer"},{"issue":"1","key":"14313_CR14","doi-asserted-by":"publisher","first-page":"e33","DOI":"10.1016\/S2468-2667(19)30219-1","volume":"5","author":"D Lewer","year":"2020","unstructured":"Lewer D, Jayatunga W, Aldridge RW, Edge C, Marmot M, Story A, et al. Premature mortality attributable to socioeconomic inequality in England between 2003 and 2018: an observational study. Lancet Public Health. 2020;5(1):e33\u201341.","journal-title":"Lancet Public Health"},{"key":"14313_CR15","doi-asserted-by":"crossref","unstructured":"Johnson P, Joyce R, Platt L. The IFS Deaton review of inequalities: a new year\u2019s message. Institute for Fiscal Studies [Internet]. 2021 [cited 2024 July 30]; Available from: https:\/\/ifs.org.uk\/sites\/default\/files\/output_url_files\/IFS-Deaton-Review-New-Year-Message.pdf.","DOI":"10.1920\/BN.IFS.2021.BN0315"},{"issue":"9","key":"14313_CR16","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1136\/jech-2022-219654","volume":"77","author":"G Chatzi","year":"2023","unstructured":"Chatzi G, Whittaker W, Chandola T, Mason T, Soiland-Reyes C, Sutton M, et al. Could diabetes prevention programmes result in the widening of sociodemographic inequalities in type 2 diabetes? Comparison of survey and administrative data for England. J Epidemiol Community Health. 2023;77(9):565\u201370.","journal-title":"J Epidemiol Community Health"},{"key":"14313_CR17","doi-asserted-by":"crossref","unstructured":"Dixon J. A constitution for the NHS [Internet]. BMJ. 2009;338. Available from: https:\/\/www.bmj.com\/content\/338\/bmj.b330.long.","DOI":"10.1136\/bmj.b330"},{"issue":"5","key":"14313_CR18","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1177\/0141076819842846","volume":"112","author":"P Littlejohns","year":"2019","unstructured":"Littlejohns P, Chalkidou K, Culyer AJ, Weale A, Rid A, Kieslich K, et al. National Institute for Health and Care Excellence, social values and healthcare priority setting. J R Soc Med. 2019;112(5):173\u20139.","journal-title":"J R Soc Med"},{"key":"14313_CR19","unstructured":"Higgins JP. Cochrane handbook for systematic reviews of interventions. Version 5.1. 0 [updated March 2011]. The Cochrane Collaboration; 2011. Available from: https:\/\/www.cochrane-handbook.org."},{"key":"14313_CR20","unstructured":"Amir-Behghadami M, Janati A, Population, intervention, comparison, outcomes and study (PICOS) design as a framework to formulate eligibility criteria in systematic reviews [Internet]. Emerg Med J. 2020 [cited 2024 Aug 2]; Available from: https:\/\/emj.bmj.com\/content\/early\/2020\/04\/05\/emermed-2020-209567?versioned=true%26casa_token=ptnSsV67ETIAAAAA:_xHDjywhN--6hLCLu-mSC8fSnx01Ld6HnCSn1LcrPaO9bOqLcVw9qEwYVzjs4VZs_l3vdloZKiKaBb-j."},{"issue":"1","key":"14313_CR21","first-page":"b92","volume":"1","author":"J Popay","year":"2006","unstructured":"Popay J, Roberts H, Sowden A, Petticrew M, Arai L, Rodgers M, et al. Guidance on the conduct of narrative synthesis in systematic reviews. Prod ESRC Methods Programme Version. 2006;1(1):b92.","journal-title":"Prod ESRC Methods Programme Version"},{"issue":"12","key":"14313_CR22","doi-asserted-by":"publisher","first-page":"1743","DOI":"10.1001\/jama.1988.03410120089033","volume":"260","author":"A Donabedian","year":"1988","unstructured":"Donabedian A. The quality of care: how can it be assessed? JAMA. 1988;260(12):1743\u20138.","journal-title":"JAMA"},{"issue":"3","key":"14313_CR23","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1111\/codi.16887","volume":"26","author":"JM Boyle","year":"2024","unstructured":"Boyle JM, Kuryba A, Blake HA, Van Der Meulen J, Fearnhead NS, Braun MS, et al. Inequalities in the recovery of colorectal cancer services during the COVID -19 pandemic: a national population\u2010based study. Colorectal Dis. 2024;26(3):486\u201396.","journal-title":"Colorectal Dis"},{"key":"14313_CR24","doi-asserted-by":"crossref","unstructured":"Shah SA, Brophy S, Kennedy J, Fisher L, Walker A, Mackenna B, et al. Impact of first UK COVID-19 lockdown on hospital admissions: Interrupted time series study of 32 million people. EClinicalMedicine [Internet]. 2022 [cited 2024 Aug 31];49. Available from: https:\/\/www.thelancet.com\/journals\/eclinm\/article\/PIIS2589-5370(22)00192-4\/fulltext.","DOI":"10.1016\/j.eclinm.2022.101462"},{"issue":"6","key":"14313_CR25","doi-asserted-by":"publisher","first-page":"1053","DOI":"10.1136\/gutjnl-2020-321650","volume":"70","author":"C Loveday","year":"2021","unstructured":"Loveday C, Sud A, Jones ME, Broggio J, Scott S, Gronthound F, et al. Prioritisation by FIT to mitigate the impact of delays in the 2-week wait colorectal cancer referral pathway during the COVID-19 pandemic: a UK modelling study. Gut. 2021;70(6):1053\u201360.","journal-title":"Gut"},{"key":"14313_CR26","doi-asserted-by":"publisher","first-page":"107076","DOI":"10.1016\/j.ypmed.2022.107076","volume":"160","author":"O Mandrik","year":"2022","unstructured":"Mandrik O, Chilcott J, Thomas C. Modelling the impact of the coronavirus pandemic on bowel cancer screening outcomes in England: a decision analysis to prepare for future screening disruption. Prev Med. 2022;160:107076.","journal-title":"Prev Med"},{"issue":"1","key":"14313_CR27","doi-asserted-by":"publisher","first-page":"e6","DOI":"10.1016\/S1470-2045(23)00511-9","volume":"25","author":"A Aggarwal","year":"2024","unstructured":"Aggarwal A, Choudhury A, Fearnhead N, Kearns P, Kirby A, Lawler M, et al. The future of cancer care in the UK\u2014time for a radical and sustainable National Cancer Plan. Lancet Oncol. 2024;25(1):e6\u201317.","journal-title":"Lancet Oncol"},{"issue":"8","key":"14313_CR28","doi-asserted-by":"publisher","first-page":"1233","DOI":"10.1038\/s41416-024-02596-9","volume":"130","author":"T Round","year":"2024","unstructured":"Round T, Sethuraman L, Ashworth M, Purushotham A. Transforming post pandemic cancer services. Br J Cancer. 2024;130(8):1233\u20138.","journal-title":"Br J Cancer"},{"issue":"23","key":"14313_CR29","doi-asserted-by":"publisher","first-page":"5924","DOI":"10.3390\/cancers13235924","volume":"13","author":"JK Ali","year":"2021","unstructured":"Ali JK, Riches JC. The impact of the COVID-19 pandemic on oncology care and clinical trials. Cancers. 2021;13(23):5924.","journal-title":"Cancers"},{"issue":"8","key":"14313_CR30","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.1038\/s41416-021-01262-8","volume":"124","author":"MA Baxter","year":"2021","unstructured":"Baxter MA, Murphy J, Cameron D, Jordan J, Crearie C, Lilley C, et al. The impact of COVID-19 on systemic anticancer treatment delivery in Scotland. Br J Cancer. 2021;124(8):1353\u20136.","journal-title":"Br J Cancer"},{"key":"14313_CR31","doi-asserted-by":"crossref","unstructured":"Boyle JM, Kuryba A, Blake HA, Aggarwal A, Van Der Meulen J, Walker K, et al. The impact of the first peak of the COVID-19 pandemic on colorectal cancer services in England and Wales: a national survey. Colorectal Dis. 2021 July;23(7):1733\u201344.","DOI":"10.1111\/codi.15622"},{"issue":"1","key":"14313_CR32","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1186\/s12889-023-15345-z","volume":"23","author":"D Bright","year":"2023","unstructured":"Bright D, Hillier S, Song J, Huws DW, Greene G, Hodgson K, et al. Inequalities in colorectal cancer screening uptake in Wales: an examination of the impact of the temporary suspension of the screening programme during the COVID-19 pandemic. BMC Public Health. 2023;23(1):546.","journal-title":"BMC Public Health"},{"issue":"8","key":"14313_CR33","doi-asserted-by":"publisher","first-page":"1361","DOI":"10.1038\/s41416-021-01275-3","volume":"124","author":"A Castanon","year":"2021","unstructured":"Castanon A, Rebolj M, Pesola F, Sasieni P. Recovery strategies following COVID-19 disruption to cervical cancer screening and their impact on excess diagnoses. Br J Cancer. 2021;124(8):1361\u20135.","journal-title":"Br J Cancer"},{"issue":"4","key":"14313_CR34","doi-asserted-by":"publisher","first-page":"904","DOI":"10.1093\/pubmed\/fdad179","volume":"45","author":"A Creavin","year":"2023","unstructured":"Creavin A, Creavin S, Kenward C, Sterne J, Williams J. Inequality in uptake of bowel cancer screening by deprivation, ethnicity and smoking status: cross-sectional study in 86 850 citizens. J Public Health. 2023;45(4):904\u201311.","journal-title":"J Public Health"},{"issue":"13","key":"14313_CR35","doi-asserted-by":"publisher","first-page":"3378","DOI":"10.3390\/cancers15133378","volume":"15","author":"S De Souza","year":"2023","unstructured":"De Souza S, Kahol de Jong J, Perone Y, Shetty S, Qurashi M, Vithayathil M, et al. Impact of COVID-19 on 1-year survival outcomes in hepatocellular carcinoma: a multicenter cohort study. Cancers. 2023;15(13):3378.","journal-title":"Cancers"},{"issue":"4","key":"14313_CR36","first-page":"261","volume":"99","author":"E Dema","year":"2023","unstructured":"Dema E, Sonnenberg P, Gibbs J, Conolly A, Willis M, Riddell J, et al. How did the COVID-19 pandemic affect access to condoms, chlamydia and HIV testing, and cervical cancer screening at a population level in Britain?(Natsal-COVID). Sex Transm Infect. 2023;99(4):261\u20137.","journal-title":"Sex Transm Infect"},{"key":"14313_CR37","doi-asserted-by":"crossref","unstructured":"Green MA, McKee M, Hamilton OK, Shaw RJ, Macleod J, Boyd A, et al. Associations between self-reported healthcare disruption due to COVID-19 and avoidable hospital admission: evidence from seven linked longitudinal studies for England. BMJ [Internet]. 2023 [cited 2025 Mar 22];382. Available from: https:\/\/www.bmj.com\/content\/382\/bmj-2023-075133.short.","DOI":"10.1136\/bmj-2023-075133"},{"key":"14313_CR38","doi-asserted-by":"publisher","first-page":"102367","DOI":"10.1016\/j.canep.2023.102367","volume":"84","author":"GJ Greene","year":"2023","unstructured":"Greene GJ, Thomson CS, Donnelly D, Chung D, Bhatti L, Gavin AT, et al. Whole-population trends in pathology-confirmed cancer incidence in Northern Ireland, Scotland and Wales during the SARS-CoV-2 pandemic: a retrospective observational study. Cancer Epidemiol. 2023;84:102367.","journal-title":"Cancer Epidemiol"},{"issue":"6","key":"14313_CR39","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1038\/s41416-021-01472-0","volume":"125","author":"AC Hamilton","year":"2021","unstructured":"Hamilton AC, Donnelly DW, Loughrey MB, Turkington RC, Fox C, Fitzpatrick D, et al. Inequalities in the decline and recovery of pathological cancer diagnoses during the first six months of the COVID-19 pandemic: a population-based study. Br J Cancer. 2021;125(6):798\u2013805.","journal-title":"Br J Cancer"},{"issue":"4","key":"14313_CR40","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1177\/0141076820982285","volume":"114","author":"S Hull","year":"2021","unstructured":"Hull S, Williams C, Basnett I, Ashman N. Health inequalities worsen with the drop in hospital referrals. J R Soc Med. 2021;114(4):158\u20139.","journal-title":"J R Soc Med"},{"issue":"1","key":"14313_CR41","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1136\/bmjnph-2021-000266","volume":"4","author":"N Jiwa","year":"2021","unstructured":"Jiwa N, Takats Z, Leff DR, Sutton C. Breast health screening: a UK-wide questionnaire. BMJ Nutr Prev Health. 2021;4(1):206.","journal-title":"BMJ Nutr Prev Health"},{"issue":"2","key":"14313_CR42","doi-asserted-by":"publisher","first-page":"e1003904","DOI":"10.1371\/journal.pmed.1003904","volume":"19","author":"E Kontopantelis","year":"2022","unstructured":"Kontopantelis E, Mamas MA, Webb RT, Castro A, Rutter MK, Gale CP, et al. Excess years of life lost to COVID-19 and other causes of death by sex, neighbourhood deprivation, and region in England and Wales during 2020: a registry-based study. PLoS Med. 2022;19(2):e1003904.","journal-title":"PLoS Med"},{"issue":"Suppl 5","key":"14313_CR43","doi-asserted-by":"publisher","first-page":"s2","DOI":"10.1136\/thorax-2023-220439","volume":"78","author":"W Man","year":"2023","unstructured":"Man W, Chaplin E, Daynes E, Drummond A, Evans RA, Greening NJ, et al. British thoracic society clinical statement on pulmonary rehabilitation. Thorax. 2023;78(Suppl 5):s2\u201315.","journal-title":"Thorax"},{"issue":"1","key":"14313_CR44","doi-asserted-by":"publisher","first-page":"e000092","DOI":"10.1136\/bmjonc-2023-000092","volume":"2","author":"V Nanton","year":"2023","unstructured":"Nanton V, Bryan RT, Pope AM, Hughes A, Jefferson K, Catto JW, et al. Boosting and broadening recruitment to UK cancer trials: towards a blueprint for action. BMJ Oncol. 2023;2(1):e000092.","journal-title":"BMJ Oncol"},{"key":"14313_CR45","doi-asserted-by":"crossref","unstructured":"Pavlatou MG, \u017darkovi\u0107 M, Heged\u00fcs L, Priestley J, McMullan C, Perros P. A survey on the psychological impact and access to health care of thyroid patients during the first SARS-CoV\u20102 lockdown. Clin Endocrinol (Oxf). 2022 Jun;96(6):869\u201377.","DOI":"10.1111\/cen.14649"},{"key":"14313_CR46","doi-asserted-by":"publisher","first-page":"e114","DOI":"10.1017\/S1460396923000390","volume":"22","author":"J Purden","year":"2023","unstructured":"Purden J, Jackson T, Tales A, Lewis R. Access and travel burden associated with breast radiotherapy attendance pre-and post-COVID-19 pandemic. J Radiother Pract. 2023;22:e114.","journal-title":"J Radiother Pract"},{"issue":"5","key":"14313_CR47","doi-asserted-by":"publisher","first-page":"1158","DOI":"10.1097\/CORR.0000000000001568","volume":"479","author":"RB Rajasekaran","year":"2021","unstructured":"Rajasekaran RB, Ashford RU, Cosker TD, Stevenson JD, Jeys L, Pollock R, et al. What proportion of patients with bone and soft tissue tumors contracted Coronavirus-19 and died from surgical procedures during the initial period of the COVID-19 pandemic? Results from the multicenter British Orthopaedic Oncology Society Observational Study. Clin Orthop Relat Res. 2021;479(5):1158\u201366.","journal-title":"Clin Orthop Relat Res"},{"issue":"2","key":"14313_CR48","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1038\/s41415-021-3718-0","volume":"232","author":"M Stennett","year":"2022","unstructured":"Stennett M, Tsakos G. The impact of the COVID-19 pandemic on oral health inequalities and access to oral healthcare in England. Br Dent J. 2022;232(2):109\u201314.","journal-title":"Br Dent J"},{"issue":"3","key":"14313_CR49","doi-asserted-by":"publisher","first-page":"e059374","DOI":"10.1136\/bmjopen-2021-059374","volume":"12","author":"T Watt","year":"2022","unstructured":"Watt T, Sullivan R, Aggarwal A. Primary care and cancer: an analysis of the impact and inequalities of the COVID-19 pandemic on patient pathways. BMJ Open. 2022;12(3):e059374.","journal-title":"BMJ Open"},{"key":"14313_CR50","doi-asserted-by":"publisher","first-page":"101914","DOI":"10.1016\/j.seps.2024.101914","volume":"94","author":"J Wen","year":"2024","unstructured":"Wen J, Santos R, Siciliani L, Proctor A. Socioeconomic inequalities in hospital access for prostate cancer before and after COVID-19. Socioecon Plann Sci. 2024;94:101914.","journal-title":"Socioecon Plann Sci"},{"key":"14313_CR51","doi-asserted-by":"crossref","unstructured":"Westrop SJ, Thomas A, Williams A, Johnson F, Liao H, Edlin K, et al. Impact of changes to invite methodology on equality of access to the National Breast Screening Programme in the South of England. J Med Screen. 2024 Jun;31(2):115\u20138.","DOI":"10.1177\/09691413231219934"},{"key":"14313_CR52","doi-asserted-by":"crossref","unstructured":"Phelan JC, Link BG. Fundamental cause theory. Medical sociology on the move: New directions in theory. Springer; 2013. pp. 105\u201325.","DOI":"10.1007\/978-94-007-6193-3_6"},{"issue":"1","key":"14313_CR53","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1093\/medlaw\/fwac028","volume":"31","author":"CA Redhead","year":"2023","unstructured":"Redhead CA, Fovargue S, Frith L, Chiumento A, Draper H, Baines PB. Relationships, Rights, and Responsibilities:(Re) viewing the NHS Constitution for the post-pandemic \u2018new normal\u2019. Med Law Rev. 2023;31(1):83\u2013108.","journal-title":"Med Law Rev"}],"container-title":["BMC Health Services Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12913-026-14313-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-026-14313-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-026-14313-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T20:56:49Z","timestamp":1781643409000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12913-026-14313-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,26]]},"references-count":53,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["14313"],"URL":"https:\/\/doi.org\/10.1186\/s12913-026-14313-8","relation":{},"ISSN":["1472-6963"],"issn-type":[{"value":"1472-6963","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,26]]},"assertion":[{"value":"6 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"405"}}