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Background Identifying psychosocial needs and satisfying them are important issues to many cancer patients. The aim of this study was to investigate the psychosocial needs of cancer patients and its related factors, based on a nationwide sample of cancer patients in Korea. Methods A multi-center survey was administered to 2661 cancer patients from 10 cancer centers in Korea. The survey measured the needs for psychosocial support, using the Comprehensive Needs Assessment Tool in Cancer, and potential correlates, such as socio-demographic and clinical factors. Multivariate ordinal regression and binary logistic regression were conducted to identify factors that may predict psychosocial needs. Results On the measure for psychosocial needs, the median score of psychological problems was 2.73 points and that of social support was 1.92 points, as the standardized score on a scale of 10 points. Needs for psychological problems were positively correlated with intensive treatment, degree of stress, problems with EQ5-D, needs for information and education, needs for hospital facilities/services and needs for physical symptoms. The need for social support was positively correlated with problems with EQ5-D and other unmet needs of cancer patients. Income levels and the number of years since diagnosis were negatively correlated with the need for social support. Conclusion Unmet psychosocial needs were common in cancer patients and have varied according to patients' socio-demographic and clinical factors. These results suggest that a psychosocial approach to treatment should be applied comprehensively and that such an approach should be matched to patients' socio-demographic and clinical circumstances. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]