English: Thank you. I'd like to begin by joining the other speakers in thanking the petitioners who raised this important issue, and also put on record my thanks to the Petitions Committee for its thoughtful consideration of the matter and its report and recommendations, and also all the speakers in the debate for their thoughtful and powerful contributions. Ovarian cancer can affect women at any age but it's more common amongst women who've been through the menopause and, as we've heard in the debate, the symptoms of ovarian cancer can be similar to those of other conditions and therefore it can be difficult to diagnose. This is an important issue for women in Wales and I hope the committee's consideration of this issue and our debate today will help raise the profile of ovarian cancer. Population screening is the process of identifying healthy people who may be at an increased risk of a disease or condition, or identifying the presence of an as-yet-undiagnosed disease or condition in a person. We then can respond through the provision of information, further tests or treatment. Screening, therefore, has the potential to identify conditions at an early and more easily treatable stage. Screening can save lives, improve your quality of life and reduce the need for costly interventions and treatments at a more advanced stage. However, it's important to understand what screening can and cannot do. Screening can save lives by identifying risks early, but it can also cause harm by identifying some factors that will never develop into a serious condition. Screening also doesn't guarantee protection. Some people may receive a low-risk result from screening but this may not prevent them from developing the condition at a later date. Population screening should only be offered where there is robust, high-quality evidence that it will do more good than harm and be cost-effective within the overall NHS budget. Where such evidence exists, the Welsh Government invests in screening programmes. I'd like to reassure you that all of our population-based, pre-symptomatic screening programmes, which range from antenatal screening of pregnant women to screening older men for aneurisms, are developed and delivered using the best available evidence and are subject to regular review. The UK National Screening Committee provide independent, expert advice on population-based screening to all UK Ministers. The committee brings academic rigour and authority to what is an extremely complex area and is a world leader in its field. The screening programmes in the UK are amongst the most respected in the world. The UK National Screening Committee has recently considered the evidence from a large UK trial into ovarian cancer screening. The evidence to date is not conclusive and the expert committee has not currently recommended screening for ovarian cancer. The UK collaborative trial of ovarian cancer screening and leading cancer charities agree that the evidence does not yet show screening can reduce deaths from ovarian cancer. As we've heard during the debate, the study did find that, for every ovarian cancer detected by screening, a number of women had unnecessary surgery, and around 3 per cent of women who had unnecessary surgery had a major complication. These and other harms, such as raised anxiety levels, will need to be carefully considered should further evidence support screening. The UK collaborative trial of ovarian cancer screening is ongoing and I understand that further evidence will be available in 2019. The UK National Screening Committee will review its recommendation when this evidence becomes available. The Welsh Government will keep the potential for a national population screening programme for ovarian cancer under review and we continue to be advised by the UK expert advisory committee on this matter. We recognise that we need to do more to identify cancers sooner. Our NHS must respond appropriately to women presenting with symptoms that require investigation. The NHS in Wales is implementing the new National Institute for Health and Care Excellence suspected cancer referral guidelines, which have lowered the threshold of suspicion and are specifically aimed at encouraging more referrals. Our current GP contract requires that each surgery reviews cases of ovarian cancer to identify opportunities to improve the care given to women. And there is now a GP lead in every health board to help primary care better identify, refer and support people affected by cancer. We'll continue to work with the NHS across Wales to improve the early detection of ovarian cancer and improve swift access to the latest evidence-based treatment. It's important that people are able to recognise symptoms and feel confident in contacting their GP. This is not just a challenge for ovarian cancer, but for a number of cancers with non-specific symptoms. An awareness campaign for ovarian cancer has recently been undertaken. The campaign was launched in March 2016 and included the distribution of leaflets and posters to all GP surgeries in Wales. This activity, together with the valued work of cancer charities and campaigners, has helped raise awareness of ovarian cancer across Wales. Our cancer delivery plan, which was launched in November 2016, includes a commitment to raise awareness of the symptoms of cancer. It is imperative that we're informed by the experts as to which cancers to target and how. Quite simply, as a layperson, I don't want to pre-empt that, and that is the reasoning behind our approach to recommendation 3. The cancer implementation group will lead on the development of future awareness-raising activity. They will consider site-specific awareness campaigns, but will also be considering the benefits of a more generic awareness-raising campaign. Proposals for a rolling awareness campaign through to 2020 are due later this year. I'd like to close by thanking the Petitions Committee for bringing this debate to the floor of the Senedd today and I'm sure the committee's scrutiny of this issue and this debate will help further raise awareness of ovarian cancer across Wales. Diolch yn fawr.
Welsh: Diolch. Hoffwn ddechrau drwy ymuno â'r siaradwyr eraill i ddiolch i'r deisebwyr a dynnodd sylw at y mater pwysig hwn, a hefyd i gofnodi fy niolch i'r Pwyllgor Deisebau am ei ystyriaeth feddylgar o'r mater a'i adroddiad a'i argymhellion, a hefyd i'r holl siaradwyr yn y ddadl am eu cyfraniadau ystyriol a phwerus. Gall canser yr ofari effeithio ar fenywod o unrhyw oedran, ond mae'n fwy cyffredin ymhlith menywod sydd wedi bod drwy'r menopos ac fel y clywsom yn y ddadl, gall symptomau canser yr ofari fod yn debyg i symptomau cyflyrau eraill ac felly gall fod yn anodd gwneud diagnosis ohono. Mae hwn yn fater pwysig i fenywod yng Nghymru ac rwy'n gobeithio y bydd ystyriaeth y pwyllgor o'r mater hwn a'n dadl heddiw yn helpu i godi proffil canser yr ofari. Sgrinio'r boblogaeth yw'r broses o nodi pobl iach a allai wynebu mwy o risg o glefyd neu gyflwr, neu nodi presenoldeb clefyd neu gyflwr nad oes diagnosis wedi'i wneud ohono hyd yma mewn unigolyn. Yna gallwn ymateb drwy ddarparu gwybodaeth, profion neu driniaeth bellach. Mae gan sgrinio botensial felly i nodi cyflyrau ar gam cynnar pan ellir eu trin yn haws. Gall sgrinio achub bywydau, gwella ansawdd eich bywyd a lleihau'r angen am ymyriadau a thriniaethau costus ar gam mwy datblygedig. Fodd bynnag, mae'n bwysig deall beth y gall sgrinio ei wneud a beth nad yw'n gallu ei wneud. Gall sgrinio achub bywydau drwy nodi risgiau'n gynnar, ond gall hefyd achosi niwed drwy nodi rhai ffactorau na fydd byth yn datblygu i fod yn gyflwr difrifol. Nid yw sgrinio yn gwarantu amddiffyniad chwaith. Efallai y bydd rhai pobl yn cael canlyniad risg isel o sgrinio, ond efallai na fydd hynny'n eu hatal rhag datblygu'r cyflwr yn ddiweddarach. Ni ddylid cynnig sgrinio poblogaeth ac eithrio lle y ceir tystiolaeth gadarn o ansawdd da y bydd yn gwneud mwy o les na niwed a'i fod yn gosteffeithiol o fewn cyllideb gyffredinol y GIG. Lle y ceir tystiolaeth o'r fath, mae Llywodraeth Cymru yn buddsoddi mewn rhaglenni sgrinio. Hoffwn eich sicrhau bod pob un o'n rhaglenni sgrinio ar sail y boblogaeth cyn i symptomau ymddangos, sy'n amrywio o sgrinio cyn-geni i fenywod beichiog i sgrinio dynion hŷn am ymlediadau, yn cael eu datblygu a'u darparu gan ddefnyddio'r dystiolaeth orau sydd ar gael ac maent yn destun adolygu rheolaidd. Mae Pwyllgor Sgrinio Cenedlaethol y DU yn darparu cyngor annibynnol, arbenigol ar sgrinio'n seiliedig ar boblogaeth i holl Weinidogion y DU. Mae'r pwyllgor yn sicrhau trylwyredd academaidd ac awdurdod mewn maes hynod o gymhleth ac mae'n arwain y byd yn ei faes. Mae'r rhaglenni sgrinio yn y DU ymhlith y mwyaf uchel eu parch yn y byd. Yn ddiweddar, bu Pwyllgor Sgrinio Cenedlaethol y DU yn ystyried y dystiolaeth o dreial mawr yn y DU i sgrinio canser yr ofari. Nid yw'r dystiolaeth hyd yma yn derfynol ac nid yw'r pwyllgor arbenigol wedi argymell sgrinio ar hyn o bryd ar gyfer canser yr ofari. Mae treial cydweithredol y DU ar gyfer sgrinio canser yr ofari ac elusennau canser blaenllaw yn cytuno nad yw'r dystiolaeth yn dangos y gall sgrinio leihau nifer y marwolaethau o ganser yr ofari. Fel y clywsom yn ystod y ddadl, gwelodd yr astudiaeth fod nifer o fenywod wedi cael llawdriniaeth ddiangen am bob canser yr ofari a ganfuwyd drwy sgrinio, a chafwyd cymhlethdodau mawr yn achos oddeutu 3 y cant o'r menywod a gafodd lawdriniaeth ddiangen. Bydd angen ystyried y rhain a mathau eraill o niwed, fel lefelau uwch o orbryder, yn ofalus pe bai tystiolaeth bellach yn cefnogi sgrinio. Mae treial cydweithredol y DU ar gyfer sgrinio canser yr ofari yn mynd rhagddo a deallaf y bydd rhagor o dystiolaeth ar gael yn 2019. Bydd Pwyllgor Sgrinio Cenedlaethol y DU yn adolygu ei argymhelliad pan ddaw'r dystiolaeth hon i law. Bydd Llywodraeth Cymru yn cadw'r posibilrwydd o gael rhaglen sgrinio poblogaeth genedlaethol ar gyfer canser yr ofari dan arolwg ac rydym yn parhau i gael cyngor gan bwyllgor ymgynghorol arbenigol y DU ar y mater hwn. Rydym yn cydnabod bod angen i ni wneud mwy i ganfod canserau'n gynt. Rhaid i'n GIG ymateb yn briodol i fenywod sydd â symptomau sydd angen eu harchwilio. Mae'r GIG yng Nghymru yn gweithredu canllawiau atgyfeirio newydd y Sefydliad Cenedlaethol dros Ragoriaeth mewn Iechyd a Gofal ar gyfer achosion lle y ceir amheuaeth o ganser, sydd wedi gostwng y trothwy amheuaeth ac wedi'u hanelu'n benodol at annog mwy o atgyfeiriadau. Mae ein contract meddygon teulu ar hyn o bryd yn mynnu bod pob meddygfa'n adolygu achosion o ganser yr ofari i nodi cyfleoedd i wella'r gofal a roddir i fenywod. A bellach, ceir arweinydd meddygon teulu ym mhob bwrdd iechyd i helpu gofal sylfaenol i wella'r modd y maent yn nodi, atgyfeirio a chefnogi pobl yr effeithiwyd arnynt gan ganser. Byddwn yn parhau i weithio gyda'r GIG ledled Cymru i wella lefelau canfod canser yr ofari yn gynnar a gwella mynediad cyflym at y driniaeth ddiweddaraf sy'n seiliedig ar dystiolaeth. Mae'n bwysig fod pobl yn gallu adnabod symptomau ac yn teimlo'n hyderus i gysylltu â'u meddyg teulu. Nid her o ran canser yr ofari yn unig yw hon, ond o ran sawl math o ganser gyda symptomau amhenodol. Cynhaliwyd ymgyrch ymwybyddiaeth o ganser yr ofari yn ddiweddar. Cafodd yr ymgyrch ei lansio ym mis Mawrth 2016 ac roedd yn cynnwys dosbarthu taflenni a phosteri i bob meddygfa yng Nghymru. Mae'r gweithgaredd hwn, ynghyd â gwaith gwerthfawr elusennau canser ac ymgyrchwyr, wedi helpu i godi ymwybyddiaeth o ganser yr ofari ar draws Cymru. Mae ein cynllun cyflawni ar gyfer canser, a gafodd ei lansio ym mis Tachwedd 2016, yn cynnwys ymrwymiad i godi ymwybyddiaeth o symptomau canser. Mae'n hanfodol ein bod yn cael gwybod gan yr arbenigwyr pa ganserau i'w targedu a sut. Yn syml, fel lleygwr, nid wyf am achub y blaen ar hynny, a dyna'r rhesymeg sy'n sail i'n hymagwedd at argymhelliad 3. Bydd y grŵp gweithredu ar gyfer canser yn arwain ar y gwaith o ddatblygu gweithgaredd codi ymwybyddiaeth yn y dyfodol. Byddant yn ystyried ymgyrchoedd ymwybyddiaeth safle-benodol, ond byddant hefyd yn ystyried manteision ymgyrch fwy cyffredinol i godi ymwybyddiaeth. Mae cynigion ar gyfer ymgyrch ymwybyddiaeth i'w chyflwyno fesul cam tan 2020 i ddod yn ddiweddarach eleni. Hoffwn gloi drwy ddiolch i'r Pwyllgor Deisebau am gyflwyno'r ddadl ar lawr y Senedd heddiw ac rwy'n siŵr y bydd gwaith craffu'r pwyllgor ar y mater hwn a'r ddadl hon yn helpu i godi ymwybyddiaeth o ganser yr ofari ar draws Cymru. Diolch yn fawr.