at least 3 chronic conditions, accounting for 40% of health care services use by seniors-an estimated total of 13.3 million health care visits in 12 months 4 . Similarly, in the United States, 28% of the population-and two of every three older Americans-have polypathology, and they account for 66% of the country's health expenditure 5 . Among Medicare beneficiaries, 96% of expenditures are already being directed to people living with multiple chronic diseases 6 , with 80% of the resources being directed to those with 5 or more conditions 5 .Within populations having cancer, it has been reported that at least 50% of survivors live with 1 or more additional chronic conditions across all ages and that polypathology is present in at least 85% of cancer survivors more than 65 years of age 7 .The impact of polypathology on mortality and treatment outcomes has also been documented [8][9][10] , but focuses mainly on older populations, with few descriptions of the impact on supportive care needs. Further, the importance of focusing on patientcentred care 10,11 and on self-management concerns 1 in populations with polypathology, and the necessity for efficient methods to assess patient care needs 10,11 have also been noted. The present study takes the first step toward filling this knowledge gap by piloting the use of self-report polypathology and supportive care needs surveys that explored the viewpoints of a convenience sample of cancer survivors (defined here as any patient having survived a diagnosis of cancer) across a spectrum of ages and cancer types and stages.
METHODSFrom June to August 2010, patients attending outpatient cancer clinics at Princess Margaret Hospital in Toronto, Ontario, were asked to complete two selfreport surveys respectively measuring polypathology and supportive care needs. General demographics and treatment history were collected at the same time. Upon completion of the surveys, feedback was collected through a short interview.
ABSTRACTWith improved average longevity, the issue of polypathology in the cancer population is of growing importance, because it will increasingly affect more people. The present study piloted two self-report surveys aiming to provide preliminary data on the nature of polypathology and supportive care needs (met and unmet) of cancer survivors. Survivors were recruited from outpatient clinics at the Princess Margaret Hospital in Toronto and were asked to complete and give feedback on the surveys. Of a convenience sample of 88 survivors, almost three quarters (73%) reported having polypathology, and 64% had at least 1 unmet need. Results also suggest that those with the highest number of needs were more likely to have polypathology. Our study invites further assessments with self-report surveys of the complex picture that arises when cancer is not the only disease affecting a person. It also highlights the need for innovative supportive services to address patient needs.