Diolch, Dirprwy Lywydd. Thank you for that. Clearly, this debate comes at a time when we've just finished a debate talking on a very similar topic, but I do not apologise for that. I did hear the Minister and I'm sure I'll hear some of the same answers again, but I think it's important we address this particular issue.

Every single one of us has been touched by cancer in some way, either ourselves or a loved one. It's hardly surprising when you consider that one in two of us is likely to develop cancer at some point in our lives. Every year around 19,300 people are diagnosed with cancer in Wales, and sadly there are around 8,800 cancer deaths. It's Wales's biggest killer, and continues to have a tremendous impact upon many people. However—. Sorry. When I spoke to the Minister—. My apologies, Dirprwy Lywydd. There is reason for optimism, however, because cancer survival has doubled since the 1970s, so that today, around half of us survive our cancer for 10 years or more, but we know that we can, and must, do better. International studies like the International Cancer Benchmarking Partnership continue to see Wales perform poorly in comparison to similar nations. If we could catch up with the best countries, many more lives could be saved.

When I spoke last in the Senedd about cancer, the world was very different. I spoke in person, rather than via technology; I was able to sit in close proximity to friends and colleagues when having a meal. Now, in a post-pandemic world, we have seen many changes to our daily lives to that we would have been doing only months ago; now no longer a responsible action to take. However, cancer hasn't gone into hiding during this pandemic. Just like the virus, it remains a threat to our health. Likewise, the approaches we take to treat cancer haven't changed, and the importance of early diagnosis hasn't changed either. The impact of COVID-19 has had a very serious, very real impact on thousands of people's cancer, and they may not even know it. Last month, Macmillan Cancer Support released a very stark report on the impact of COVID-19 on cancer care. It highlighted that during the peak of the pandemic, there were 31 per cent fewer patients than usual entering the single cancer pathway. Data from Cancer Research UK shows that for March 2020 to August 2020, there were around 18,200 fewer urgent referrals for suspected cancer from GPs in Wales, with the biggest fall in urgent referrals occurring in April—the height of the lockdown—when the number of referrals was 63 per cent lower than in April 2019. 

The latest cancer waiting times released from 19 November show that around 7,100 people diagnosed with cancer started treatment between April and September in Wales—a figure showing approximately 1,500 fewer people than in the same period the previous year. The same data identified that only 74 per cent of patients with an urgent referral for suspicion of cancer received a test and started treatment within 62 days in September, the target being 95 per cent. This compares to 80 per cent of patients with an urgent referral for suspected cancer starting the treatment at the same time last year. And lung cancer has been the slowest to recover, with regard to the number of urgent suspected cancer referrals—an almost 72 per cent drop in April, still down to a 26 per cent drop in August. Between March and August, the pausing of cancer screening programmes across the UK meant that 3 million people weren't invited to one of the three cancer screening programmes—bowel, breast, cervical. Modelling by Cancer Research UK suggests that every month, 55,600 people would normally be invited to take part in one of these three cancer screening programmes in Wales, leading to the diagnosis of at least 80 cancers, plus additional pre-cancerous changes detected and treated. Now, 40 per cent of Welsh respondents reported that cancer testing they would usually expect was delayed, cancelled or altered. About 27 per cent said that their cancer treatment was affected.

Like other Members, I have heard many experiences of people whose cancer tests and treatments were in some way affected by COVID-19. It has caused considerable anxiety and, most worryingly, concerns that cancer survival could be negatively affected. During the first wave of the pandemic, the number of people waiting for a diagnostic endoscopy increased from around 11,900 by the end of March to around 15,700 at the end of July. As we all know, early diagnosis is critical to improving cancer survival in Wales. For example, when bowel cancer is diagnosed at stage 1, over nine in 10 patients survive, but this drops to fewer than one in 10 if it is diagnosed at stage 4. It is estimated that this will lead to a backlog of approximately 2,900 missing diagnoses over this six-month period. It is vital that we increase cancer diagnostic capacity to at least the level it was pre-pandemic, in order to avoid too many patients entering the pathway but having to wait for diagnostics, which will—[Inaudible.]