AbstractA total of 520 patients were assessed within 8 weeks of diagnosis to explore the effect of age on psychological adjustment to cancer. Patients with cancers of the breast, colon, testicle, female reproductive tract and with lymphoma were included. Three measures of adjustment were used: DSM‐III diagnoses of depression and/or anxiety, frequency of specific concerns and the total number of patient concerns. For depression and anxiety diagnoses combined, the cases were significantly younger than the non‐cases (mean = 49.4 versus 53.7 years,p<0.01). Younger patients also had significantly higher concern scores (p<0.001). Younger patients were more likely to report concerns relating to the illness itself, treatment, feeling different, feeling upset, the future, finances, relationship with partner and others and sexuality. No age effect was seen for more practical concerns relating to physical symptoms, restriction of activities, job or amount of support received. Younger patients appear to experience greater difficulties adjusting to a cancer diagnosis but particular attention should be paid to the practical issues faced by older cancer patie