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Factors measured were breast cancer worry, perceived risk, cognitive appraisals, coping, dispositional optimism, and background variables relating to screening history and family history.<\/jats:p><jats:p><jats:italic>Results<\/jats:italic>: Pre\u2010screening cancer worry was the most important predictor of subsequent worry, explaining 56\/61% and 54\/57% of the variance at one and six months follow\u2010up, respectively. Other salient pre\u2010screening predictors included high perceived risk of breast cancer, appraisals of high relevance and threat associated with the family history, and low perceived ability to cope emotionally. Women who had previously been part of the screening programme and those with a relative who had recently died from breast cancer were also vulnerable to longer\u2010term distress. A false positive screening result, pessimistic personality, and coping efforts relating to religion and substance use predicted outcomes of screening at one month follow\u2010up, but were not predictive in the longer\u2010term.<\/jats:p><jats:p><jats:italic>Conclusion<\/jats:italic>: Early intervention to ameliorate high levels of cancer\u2010related distress and negative appraisals would benefit some women as they progress through the familial breast screening programme. 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