This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/pon.4548 This article is protected by copyright. All rights reserved. A cross-cultural convergent parallel mixed methods study of what makes a cancer-related symptom or functional health problem clinically important Johannes M. Giesinger 1 , Neil K. Aaronson 2 , Juan I. Arraras 3 , Fabio Efficace 4 , Mogens Groenvold 6 , Jacobien M Kieffer 2 , Fanny LC Loth 1 , Morten Aa. Petersen 6 , John Ramage 5 , Krzysztof A. Tomaszewski 7 , Teresa Young 8 , Bernhard Holzner 1 on behalf of the EORTC Quality of Life Group 1) Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria 2) Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands 3) Medical Oncology Department, Hospital of Navarre, Pamplona, Spain 4) Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA) Data Center, Rome, Italy 5) Department of Gastroenterology and Hepatology, Hampshire Hospitals NHS Foundation Trust, Aldermaston Road, Basingstoke, RG24 9NA, UK 6) The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, and Department of Public Health, University of Copenhagen, Copenhagen, Denmark 7) Health Outcomes Research Unit, Department of Gerontology, Geriatrics, and Social Work, Ignatianum Academy, Krakow, Poland 8) Lynda Jackson Macmillan Centre, Mount Vernon Cancer Centre, Northwood, UK