A study of 2776 cancer patients found that 37.8% experienced clinical levels of distress, with higher rates among men for somatisation and women for depression. Distress was more common in minority patients, those with lower income, and those with cancers other than prostate. Lung, pancreatic, head and neck, Hodgkin's disease, and brain cancer patients were the most distressed. Almost half of those with distress had not sought psychosocial support. Distress was common across cancer types and disease stages, and many patients were not using available psychosocial resources. Barriers to using these resources and factors predicting distress require further exploration. The study highlights the need for improved screening and referral systems to ensure patients receive appropriate psychosocial care. Distress is a significant and ongoing issue in cancer care, and psychosocial interventions are effective in reducing distress and improving quality of life. However, many patients do not seek these services, possibly due to lack of awareness, stigma, or other barriers. The study underscores the importance of integrating psychosocial care into routine cancer treatment and developing effective screening and triage systems to ensure all patients receive the support they need.A study of 2776 cancer patients found that 37.8% experienced clinical levels of distress, with higher rates among men for somatisation and women for depression. Distress was more common in minority patients, those with lower income, and those with cancers other than prostate. Lung, pancreatic, head and neck, Hodgkin's disease, and brain cancer patients were the most distressed. Almost half of those with distress had not sought psychosocial support. Distress was common across cancer types and disease stages, and many patients were not using available psychosocial resources. Barriers to using these resources and factors predicting distress require further exploration. The study highlights the need for improved screening and referral systems to ensure patients receive appropriate psychosocial care. Distress is a significant and ongoing issue in cancer care, and psychosocial interventions are effective in reducing distress and improving quality of life. However, many patients do not seek these services, possibly due to lack of awareness, stigma, or other barriers. The study underscores the importance of integrating psychosocial care into routine cancer treatment and developing effective screening and triage systems to ensure all patients receive the support they need.