The aims of this study are to establish in Japanese radiation oncology patients’: 1) The proportion of likely cases of anxiety, depression, and overall distress as identified by the Hospital Anxiety and Depression Scale (HADS); and 2) the agreement between patients’ self-reported anxiety and depression levels and HADS classifications. Eligible participants are adult cancer patients attending radiation therapy appointments in a Japanese university hospital. Patients providing informed consent complete a touchscreen computer survey assessing demographic and disease characteristics; perceived anxiety and depression levels; and the HADS. Our accrual target is 200. After one month of recruitment, 40 patients have completed the survey.Preliminary findings suggest that 20% (95% CI: 9.0-36%) of patients are likely cases of moderate-severe depression, and 13% (95% CI: 4.2-27%) are likely cases of moderate-severe anxiety. Thirty-three percent (95% CI: 19-49%) of patients are likely cases of general psychological distress (overall score ≥15). Ten percent of patients (95% CI: 2.8-24%) indicated that they would like to be offered some professional support for their current levels of anxiety and/or depression. Agreement between self-reported anxiety and HADS classified likely anxiety is currently 79% (slight-moderate; Cohen's κ = 0.2, 95% CI: 0.1, 0.6). For depression agreement between patient self-reported depression and HADS classified likely depression is 82% (none-substantial; κ = 0.3, 95% CI: -0.08, 0.7). Agreement between having a current desire to be offered support and HADS classified likely anxiety is 89% (κ = 0.4, 95% CI:-0.01, 0.9) and depression 79% (κ = 0.2, 95% CI: -0.1, 0.6). Assessment of psychological distress using touchscreen computers in Japanese radiotherapy treatment settings appears to be feasible. Patients’ perceptions of levels and/or desire for support for psychological distress may be a useful first step in a staged approach for distress screening in this setting.