Thank you, Deputy Presiding Officer. I’m very pleased to open this debate on the Petitions Committee report on a petition received calling for a national screening programme for ovarian cancer. This petition was organised by Margaret Hutcheson, and was supported by 104 people. Ms Hutcheson, a retired palliative care nurse, was inspired to start the petition after several of her friends had been diagnosed with ovarian cancer. Her primary concern was to improve timely diagnosis and treatment of this terrible disease. Her main ambitions for the petition were for a national screening programme for ovarian cancer, and increased awareness of ovarian cancer and its symptoms amongst health professionals and the general public. As a committee, we held oral evidence sessions with the petitioner, the Minister for Social Services and Public Health, and we also wrote to cancer charities to seek their views. We as a committee are grateful to the Welsh Government, Cancer Research UK, Ovarian Cancer Action, and Target Ovarian Cancer, who all provided their views on the subject of the petition.

Ovarian cancer is responsible for around 240 deaths each year in Wales—or, in terms we understand, six per constituency—and is one of the major causes of mortality in women in the UK. One in 50 women will have ovarian cancer at some point in their lives and, tragically, less than half of women diagnosed with ovarian cancer are alive five years after diagnosis. Evidence we received also indicated that survival rates in the UK are lower than the European average. Margaret Hutcheson, the petitioner, was accompanied by her friend Jenny Chapman to answer the committee’s questions, and I would like to place on record the committee’s sincere thanks to both of them for coming along and giving us their views.

All the views we heard support the importance of early identification of the symptoms of ovarian cancer. Doesn’t that sound common for all cancers? Early diagnosis improves the chances of successfully defeating the disease, and I think that that is something that we perhaps need to say more and more often. We heard that there’s a close correlation between early diagnosis and the outlook for women receiving that diagnosis. Whilst this is not unique to ovarian cancer, the committee did hear that ovarian cancer can be particularly difficult to diagnose. This is because the common symptoms are easily mistaken for either other conditions, or there are no symptoms at all. For these reasons, by the time most women with ovarian cancer develop symptoms and their cancer is detected, it has spread outside the ovaries and is far more difficult to treat successfully.

Figures we received from Cancer Research UK showed that the five-year ovarian cancer survival rate in England and Wales is 46 per cent, or, put the other way, 54 per cent die within five years. However, amongst women diagnosed at the earliest stage, this increases to 90 per cent. So, over a third more women who are diagnosed at the early stage survive than would if they waited until the later stage. We believe this represents a convincing case for taking further action to increase the number of women with ovarian cancer receiving an early diagnosis.

This petition primarily called for the introduction of a screening programme to detect early-stage ovarian cancer. The petitioner argued strongly this could help save the lives of women who develop cancer. The petitioner made the case that this should involve women receiving an annual blood test aimed at detecting early-stage ovarian cancer. In her evidence to committee, Margaret Hutcheson suggested the programme should specifically target all women aged over 50. Ovarian cancer screening is not currently available on the NHS in Wales, nor in any other part of the UK.

The committee heard that studies to find a general population screening test for ovarian cancer are currently ongoing. The largest of these is the UK collaborative trial of ovarian cancer screening, which has been running since 2001. Findings were published in December 2015. They indicated there could be benefits from conducting screening using blood tests, but these were inconclusive overall. As a result, the study has been extended for another three years.

In her evidence, the Minister for Social Services and Public Health outlined the process through which Welsh Government takes its advice from a UK national screening committee, which advises all UK Governments. We learned that the screening committee has recently reviewed its recommendation about ovarian cancer screening and their existing recommendation remains for no population screening at this stage.’

We also heard concerns about the accuracy of the most common blood test for ovarian cancer, the CA125 test. Women with ovarian cancer tend to have high levels of the CA125 protein in their blood—more than women who do not have ovarian cancer. But CA125 can also be raised for a number of non-cancerous reasons. This means there is a significant risk of false positives. We heard it is possible that only 1 per cent of women referred to secondary care following a CA125 blood test would actually have ovarian cancer, and I think that one of the things we did feel was that we don’t want people to be frightened of something when the chances of them having it are that low. Therefore, the research currently indicates that the test is not currently accurate enough to be used as part of a screening programme.

Having given careful consideration to the range of evidence the committee received, on balance, we accept that the current evidence does not support the introduction of a population screening programme. However, given the study is still under way and will report further findings in the coming years, we recommend that Welsh Government should keep the situation under close review and give detailed consideration to any evidence in relation to a new national screening programme. Given that early diagnosis is so important in cases of ovarian cancer, an effective screening programme could play a vital role in improving survival rates, and I am pleased that the Minister accepted this recommendation.

As stated earlier, though we are not able to support a national screening programme, we felt as a committee that other measures taken to improve early identification of ovarian cancer—. I will now turn to those.

The need to increase public awareness of ovarian cancer was the central theme of the evidence we received. The petitioner expressed concern that public awareness of the condition is extremely low and described ovarian cancer as a ‘silent killer’. We heard that a leaflet on ovarian cancer, including common symptoms of the disease, is available through GP surgeries, and the Velindre NHS Trust ran a month-long awareness campaign in March 2016. As part of this, information packs for GPs were produced by the charity Target Ovarian Cancer. We welcome these actions and the efforts taken to increase public awareness of ovarian cancer and the common symptoms.

Nevertheless, we feel that more could and should be done to ensure greater numbers of women are aware of the disease. Building awareness is the key, because, once they become aware of it and become aware of the symptoms, then there’s a greater chance of them going to see their GP and getting a referral. We have recommended the Welsh Government should do more to improve public awareness of ovarian cancer, including the common symptoms and when people should seek medical advice. We would like to see this build upon previous work and run over a prolonged period.

I recognise there is merit in raising the public profile of a large number of conditions and diseases. However, the evidence we received convinced us there should be a focus on ovarian cancer specifically because of the vital importance of detecting the disease at the earliest possible stage. This was strongly supported by the petitioner and by the charities we contacted. For example, Ovarian Cancer Action told us that:

Funding would be better spent at this time on a national symptoms public awareness campaign.’

I must say I am very disappointed the Minister has declined this recommendation. I hope that in the ministerial reply she will be able to explain how a commitment to raising awareness of the symptoms of cancer generally within the cancer delivery plan will have the desired effect of raising awareness of ovarian cancer.

Our final recommendation concerns professional awareness of ovarian cancer. It is imperative that all women can receive timely tests and diagnosis when ovarian cancer is a possibility. Women who present with ovarian cancer symptoms must be able to access the appropriate diagnostic tests quickly so that optimal treatment is available to them. The evidence received was clear about the importance of awareness of ovarian cancer amongst health professionals. In particular, it is crucial that GPs—who, for most people, is the first person they see when they have symptoms that make them unwell—are consistently able to recognise the symptoms of ovarian cancer and appropriately refer people for diagnostic tests. What we don’t want is GPs not knowing about it, sending them back and telling them to come back in three months’ time if they haven’t got any better, because that will mean the time they have to wait to be dealt with will increase and their chances of survival will decrease.

We were pleased to hear that recent work has been carried out in relation to GP awareness in Wales, and the Minister spoke of her intention to continue to improve the understanding of symptoms and early diagnosis of ovarian cancer by clinicians. The committee noted that this is already a priority area in GP contracts and that GPs were required to review every case of ovarian cancer detected in 2015 in order to help learn lessons in relation to diagnosis and referral.

We recommended that the Government continues this work and supports primary care cancer leads to use the learning from this review to inform plans in each health board aimed at improving early diagnosis. I’m very glad that the Deputy Minister accepted that recommendation.

In conclusion, Llywydd, I’d like to reiterate that the committee fully supports the motivation behind the petition. Whilst the evidence does not currently support the call for national screening of all women, we believe there’s strong evidence of the importance of seeking to develop greater awareness of ovarian cancer amongst the public and health professionals. I hope our report and the debate this afternoon will help contribute in some small way towards this.

Finally, I would like to place on record the committee’s thanks to Margaret Hutcheson for using the petitions process to bring this matter to the Assembly’s attention, and for her hard work and enthusiasm throughout the process. I would also like to thank the members of the committee and the staff who helped in our consideration of the petition and the production of our report. If only one woman gets diagnosed early enough to save her life, it will be worth while.