OBJECTIVES: The National Comprehensive Cancer Network and American College of Surgeons Commissions on Cancer requires cancer centers to evaluate psychosocial distress and provide appropriate triage and treatment for all patients(Standard 3.2). Clinically-significant distress includes biopsychosocial stressors which are highly prevalent in individuals with cancer and lead to negative health outcomes. Currently programs identifying veteran’s distress are limited and can help clarify treatment needs and improve future outcomes. METHODS:  Participants were screened during their initial oncology consult visit utilizing the biopsychosocial “NCCN Distress Thermometer and Problem List for Patients”(n=53). The majority of patients were men(87%), mean age 70(SD=8.16) presenting with cancer of the lung(23%), prostate(15%), GI(13%), ENT(13%), and others. Distress scores ranging between 0 and 3 resulted in documentation in the electronic medical record; those >4 received telephone follow-up and triage to appropriate care clinics. RESULTS: The mean distress score was 3.72, falling below the “significant distress cutoff” with the median of 4.00, meeting significant distress. Overall, 47 percent reported significant distress related to physical, psychological, social, and spiritual needs(score>4). Eight percent reported severe, significant distress(score>7). Further analysis identified fatigue(47%), pain(43%) worry(41%), and insurance/financial concerns(31%) as primary symptoms of distress. For the 47% who reported significant distress, symptoms included significant worry(67%), pain(59%), fatigue(51%), nervousness(48%), sleep(44%), and loss of interest(41%), with primarily emotional health symptoms and physical health symptoms secondary. Interestingly, 33% reported distress scores below 4, yet marked experiencing significant symptoms physical and psychological symptoms. Three patients reported active suicide ideation/plan and were provided care accordingly. CONCLUSIONS: A large majority of veterans receiving oncological care reported significant cancer-related distress and unmet needs, with elevated symptoms of emotional and physical demands. There may be a continued trend towards under-reporting among veterans, such that as individuals reporting low scores of distress nevertheless endorsed emotional and physical symptomatologies to marked degrees.