Objective Although effective treatments for pain and distress are available, many patients do not access them. Improved understanding of patients' desire for help may improve uptake of services. Methods Data were collected as part of the QUICATOUCH screening program at an Australian regional hospital. Patients over threshold for pain were asked if they would like help with their pain and those over threshold for distress were asked if they would like help with their distress. Multivariate logistic regression analyses were conducted to identify independent predictors of desire for help. Results Of 305 patients over threshold for pain; 59% wanted help, increasing from 13% at a pain score of one to 90% at a pain score of 10. Of 274 patients over threshold for distress, 30% wanted help, increasing from 21% at a distress score of four to 41% at a distress score of 10. Pain score was the only significant independent predictor of desire for help with pain, with an odds ratio (OR) of 1.50 (95%CI 1.33-1.70) for every point increase in pain score. Distress score was the only significant independent predictor of desire for help with distress with an OR of 1.29 (95%CI 1.11-1.50) for every point increase in distress score. Conclusions Although desire for help with pain and distress increased with respective symptom intensity, many patients indicated they did not want help with these symptoms. Patient reluctance to seek help may constitute a barrier to realising the full potential of screening programs in reducing pain and distress. Copyright © 2012 John Wiley & Sons, Ltd. Copyright © 2012 John Wiley & Sons, Ltd.