There is a need to identify TC survivors at risk of poorer outcomes and for interventions to target the areas of greatest impairment (i.e., psychological distress and mental HRQOL).

Objective: This cross-sectional study aimed to identify the prevalence and correlates of supportive care needs in testicular cancer (TC) survivors. Methods:Men who had completed active anti-cancer treatment for TC between 6 months and 5 years previously showing no evidence of recurrence were recruited from 14 Australian cancer centres (September 2009 -February 2011. Participants completed a self-report questionnaire measuring sociodemographics, disease and treatment information, supportive care needs (CaSUN), psychological distress (DASS21) and health-related quality of life (HRQOL; SF36v2).Results: Of the 486 eligible TC survivors invited to participate, 244 completed the questionnaire. Sixty-six percent reported one or more unmet supportive care needs. The mean number of unmet needs was 4.73 (SD=7.0, Range=0-34). The most common unmet needs related primarily to existential survivorship issues (e.g. life stress) and relationships (e.g. sex life). Younger age and presence of chronic illness other than TC were significantly associated with higher number of unmet needs. Number of unmet needs was more highly correlated with psychological distress and HRQOL than unmet need strength. Conclusions:The majority of TC survivors reported one or more unmet needs. Unmet needs regarding existential survivorship issues were frequently reported by TC survivors despite their favorable prognosis. Relationships unmet needs were less prevalent, but still more common than in breast and gynecological cancer survivors. These findings appear to be related to the young age of TC survivors. As higher number of unmet needs is significantly associated with psychological morbidity and impaired HRQOL, interventions addressing this constellation of issues are needed. KeywordsTesticular cancer, Survivor, Supportive care needs, Psychological distress, Health-related quality of life, Oncology 3 Introduction Testicular cancer (TC) is the most prevalent cancer (excluding skin) in men aged 15-35 years [1] and its incidence is rising, particularly among Caucasians [2]. Advances in diagnosis and treatment, particularly cisplatin-based chemotherapy, have achieved cure rates exceeding 95% [3], resulting in increasing numbers of TC survivors. There is a growing awareness of cancer survivors' supportive care needs [4], commonly defined as "the requirement of some action or resource that is necessary, desirable, or useful to attain optimal well-being" [5; p227]. Needs are considered met if the required action/resource has been provided, or unmet if not. Identification of unmet needs can guide assessment, planning and delivery of services to improve TC survivors' psychological wellbeing and health-related quality of life (HRQOL) [6].

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