Background: Germ cell tumours are the most common cancer of male adolescents and young adults (AYA, age 18-39). Men in this age group have been healthy much of their lives, and are at a stage of personal and professional growth, consequently a diagnosis of cancer can cause significant psychosocial distress. We evaluated patient reported psychosocial distress and hypothesized that AYA compared to older patients experienced more anxiety and distress in emotional, practical and physical domains. Methods: All patients referred to BC Cancer complete the Psychosocial Screen for Cancer (PSSCAN-R) at first consultation. This is a validated screening questionnaire for distress. Components include a screen for subclinical/clinical symptoms of depression and anxiety and the Canadian Problem Checklist (CPC) with 6 domains of concern: emotional, informational, practical, spiritual, social/family and physical. Results: Data was collected for 349 patients from 2011-2015. Baseline characteristics: 227 (65%) AYA, median age 33 (range 18-83), 41 (11%) metastatic disease at diagnosis. The top 3 AYA concerns were work/school (38.3%), financial (34.8%), frustration and anger (26%). AYA patients scored positive for subclinical/clinical anxiety more commonly than their older counterparts (39.4% vs. 27.9%, p = 0.028). AYA patients with subclinical/clinical anxiety symptoms experienced more fears and worries (41.5%), concerns regarding work/school (38%), lack of understanding of their disease (37.9%), finances (35.3%) and frustration and anger (26.3%) than AYA patients who do not express anxiety symptoms. Conclusions: The results of this study indicate that AYA with testicular cancer have unique needs and experience significantly more self-reported anxiety symptoms with emotional, informational, and practical concerns. Programs tailored to address needs of AYA patients may help reduce anxiety and improve the cancer experience. The results of this study are valuable to stakeholders for allocation of resources to address psychosocial parameters of distress in this patient group.