To investigate whether physicians perceive concerns of cancer patients in the same way as patients, we asked primary care physicians and cancer patients to complete an instrument that allowed each to indicate their views of the relative importance of a variety of treatment and disease-related concerns. The instrument was completed by 195 physicians (56% response) and 119 newly diagnosed breast, lung, and colorectal cancer patients (50% response). Psychometric analysis of responses to the instrument revealed two components: general concerns and physician-treatment concerns. For both the physician and the patient groups, internal consistency (coefficient alpha) of these two components was high (greater than .83). Within the patient group, scale scores did not differ as a function of performance status, cancer type, extent of disease, or age. For physicians, scale scores were not related to years in practice, board certification, or number of new cancer patients seen per year. A comparison of scale scores between groups indicated that there was good physician-patient congruence on only one of the two concern components. Physicians do not adequately appreciate the extent of concern patients have with regard to treatment and physician interaction issues.