Purpose: The importance of distress identification and management in oncology has been established. We examined the relationship between distress and unmet bio-psychosocial needs, applying advanced statistical techniques, to identify which needs have the closest relationship to distress. Methods: Oncology outpatients (n = 1066) undergoing QUICATOUCH screening in an Australian cancer centre completed the distress thermometer (DT) and problem list (PL). Principal component analysis (PCA), logistic regression and classification and regression tree (CART) analyses tested the relationship between DT score (at a cut-off point of 4) and PL items. Results: Sixteen items were reported by