English: Diolch yn fawr. Thank you for the opportunity to respond to the debate today. I know that it has really produced some very strong responses from across our communities, and the tone and the passion that we've seen in the debate this afternoon demonstrates that this has touched many, many people. So, I would like to thank people for engaging in the conversation, but clearly there is a need to learn some lessons here. As you've all pointed out, this follows a petition calling on the Welsh Government to reinstate cervical screening to every three years. This was announced by Public Health Wales on 4 January and the idea was to extend the routine screening interval for people aged 25 to 49 from three to five years if high-risk HPV is not found in their cervical screening test. And that will bring the screening interval into line with those aged 50 to 64. Many this afternoon have pointed out the calamitous way in which this was communicated. Public Health Wales has apologised and I met with them earlier this week, where they were at pains to tell me that they have learned the lessons, that they understand the anger and the concern that people felt because of their failure to communicate in an adequate way. And it is important, I think, that Public Health Wales is reviewing its approach now to communicating public health messages following that feedback. It's important to note that the interval change will not apply to those who are found to have high-risk HPV, with or without cell changes, as they will be offered annual screening and further tests as necessary. And that's the point, that's what we're doing here is really focusing on those people who are more at risk. This change is fully supported, as many have pointed out today, by the main cancer charities, and I've got to emphasise that this has not been made to save resources. Investing in preventative services, such as screening, and detecting cancers at earlier stages makes them easier and more cost-effective to treat. The change has also not been made due to the success of the HPV vaccination programme in schools, although that has been successful, and I was asked by Jack what the rates are. The rates last week in terms of the uptake of vaccine in year 8, which is 12 to 13-year-olds, was around 71 per cent. So, far fewer than we'd hoped, but there will be a catch-up immunisation programme that we'll be looking to roll out - obviously it's a very disruptive year in our schools. And those people who've had the vaccination, they're only now entering the age cohort for the screening programme, although it's expected that in future the combination of vaccination and screening should see cervical cancers decline significantly in the near future. The Welsh Government follows the advice of the UK National Screening Committee, which recommended that all nations implement the new cervical screening test and interval change because the new testing method is more accurate. The UK National Screening Committee is an independent scientific advisory committee that reports to all four UK chief medical officers, and is recognised globally for its expertise and its academic rigour. It requires a very high level of evidence, and its recommendations are based on years of research and public consultation. And that's, I guess, the frustration with this, that this should have been a good news story and, somehow or other, it's created a real sense of anxiety within our communities. The aim of the cervical screening programme is to reduce the incidence of and mortality from cervical cancer. This is by detecting and treating changes at the cervix before they develop into cancer. But the new test, which was introduced in Wales in 2018, before any other part of the United Kingdom, I think it's important to state, is not a test for cancer itself. It helps to protect against cervical cancer by identifying the virus that causes it. Current screening looks for the presence of high-risk human papillomavirus, which causes nearly all cervical cancers. The data that Jenny Rathbone pointed out, I think, are accurate and should be considered. The new improved test involves the same procedure as the previous screening, whereby a sample is taken from the cervix, but instead of looking at abnormal cells, the sample is tested for HPV first. As having a high-risk HPV infection comes before abnormal cells develop, HPV primary testing detects people at risk of developing cervical cancer at a much earlier point. If HPV is found, the sample is then also checked for cell changes and followed up with further tests if changes are present. If abnormal cells are not present, the person will be invited for screening again in one year's time. So, it's important to remember that if you don't have HPV, then there is a different system for those who are found to be higher risk. If no high-risk HPV is found in the sample, the person will be invited for screening in five years' time. And that interval change will apply to people whose next routine screening result shows that they don't have high-risk HPV, and this is because their risk of developing cervical cancer within the five years following their screening is very low.
Welsh: Diolch yn fawr. Diolch am y cyfle i ymateb i'r ddadl heddiw. Gwn ei bod wedi cynhyrchu ymatebion cryf iawn ar draws ein cymunedau, ac mae'r cywair a'r angerdd a welsom yn y ddadl y prynhawn yma yn dangos bod hyn wedi cyffwrdd â llawer iawn o bobl. Felly, hoffwn ddiolch i bobl am gymryd rhan yn y sgwrs, ond yn amlwg mae angen dysgu gwersi yma. Fel y dywedodd pawb, daw hyn yn sgil deiseb yn galw ar Lywodraeth Cymru i adfer y drefn sgrinio serfigol bob tair blynedd. Cyhoeddwyd hyn gan Iechyd Cyhoeddus Cymru ar 4 Ionawr a'r syniad oedd ymestyn y cyfnod sgrinio rheolaidd ar gyfer pobl rhwng 25 a 49 oed o dair i bum mlynedd os na cheir HPV risg uchel yn eu prawf sgrinio serfigol. A bydd hynny'n sicrhau bod y cyfnod sgrinio yn cyd-fynd â'r hyn ydyw i rai rhwng 50 a 64 oed. Mae nifer wedi tynnu sylw y prynhawn yma at y ffordd y cafodd hyn ei gyfathrebu. Mae Iechyd Cyhoeddus Cymru wedi ymddiheuro a chyfarfûm â hwy yn gynharach yr wythnos hon, ac roeddent yn hynod o awyddus i ddweud wrthyf eu bod wedi dysgu'r gwersi, eu bod yn deall y dicter a'r pryder a deimlai pobl oherwydd eu methiant i gyfathrebu mewn ffordd ddigonol. Ac rwy'n credu ei bod hi'n bwysig fod Iechyd Cyhoeddus Cymru bellach yn adolygu ei ddull o gyfathrebu negeseuon iechyd y cyhoedd yn dilyn yr adborth hwnnw. Mae'n bwysig nodi na fydd y newid yn y cyfnod yn berthnasol i'r rhai y canfyddir bod ganddynt HPV risg uchel, gyda neu heb newidiadau celloedd, gan y byddant yn cael cynnig sgriniad blynyddol a phrofion pellach yn ôl yr angen. A dyna'r pwynt, yr hyn a wnawn yma yw canolbwyntio'n wirioneddol ar y bobl sy'n wynebu mwy o risg. Fel y mae nifer wedi'i nodi heddiw, cefnogwyd y newid hwn yn llawn gan y prif elusennau canser, ac mae'n rhaid imi bwysleisio nad yw hyn wedi'i wneud i arbed adnoddau. Mae buddsoddi mewn gwasanaethau ataliol, megis sgrinio, a chanfod canserau ar gamau cynharach yn eu gwneud yn haws ac yn fwy costeffeithiol i'w trin. Nid yw'r newid wedi'i wneud ychwaith oherwydd llwyddiant y rhaglen frechu HPV mewn ysgolion, er bod honno wedi bod yn llwyddiannus, a gofynnodd Jack beth yw'r cyfraddau. Y cyfraddau yr wythnos diwethaf o ran y nifer sy'n manteisio ar y brechlyn ym mlwyddyn 8, sef pobl ifanc 12 i 13 oed, oedd tua 71 y cant. Felly, mae'n llawer llai nag y byddem wedi'i obeithio, ond byddwn yn ceisio cyflwyno rhaglen imiwneiddio dal i fyny - yn amlwg, bu'n flwyddyn lle cafwyd llawer o darfu ar ein hysgolion. A dim ond yn awr y mae'r bobl sydd wedi cael y brechiad yn cyrraedd y garfan oedran ar gyfer y rhaglen sgrinio, er y disgwylir y dylai'r cyfuniad o frechu a sgrinio arwain at gyfraddau sylweddol is o ganser ceg y groth yn y dyfodol agos. Mae Llywodraeth Cymru yn dilyn cyngor Pwyllgor Sgrinio Cenedlaethol y DU, a argymhellodd y dylai pob gwlad weithredu'r prawf sgrinio serfigol newydd a'r newid yn y cyfnod rhwng profion oherwydd bod y dull profi newydd yn fwy cywir. Pwyllgor cynghori gwyddonol annibynnol yw Pwyllgor Sgrinio Cenedlaethol y DU sy'n adrodd i bob un o bedwar prif swyddog meddygol y DU, ac mae'n cael ei gydnabod yn fyd-eang am ei arbenigedd a'i drylwyredd academaidd. Mae'n galw am lefel uchel iawn o dystiolaeth, a seilir ei argymhellion ar flynyddoedd o ymchwil ac ymgynghori â'r cyhoedd. Ac rwy'n tybio mai dyna yw achos y rhwystredigaeth gyda hyn, y dylai fod wedi bod yn newyddion da a rywsut neu'i gilydd, mae wedi creu teimlad gwirioneddol o bryder yn ein cymunedau. Nod y rhaglen sgrinio serfigol yw lleihau nifer yr achosion o ganser ceg y groth a'r nifer sy'n marw ohono. Mae'n gwneud hyn drwy ganfod a thrin newidiadau yng ngheg y groth cyn iddynt ddatblygu'n ganser. Ond rwy'n credu ei bod hi'n bwysig dweud nad prawf am ganser ei hun yw'r prawf newydd a gyflwynwyd yng Nghymru yn 2018, cyn unrhyw ran arall o'r Deyrnas Unedig. Mae'n helpu i ddiogelu rhag canser ceg y groth drwy ganfod y feirws sy'n ei achosi. Mae sgrinio cyfredol yn chwilio am bresenoldeb feirws papiloma dynol risg uchel, sy'n achosi bron bob canser ceg y groth. Credaf fod y data a nododd Jenny Rathbone yn gywir a dylid ei ystyried. Mae'r prawf newydd gwell yn dilyn yr un drefn â'r sgriniad blaenorol, lle cymerir sampl o geg y groth, ond yn hytrach nag edrych ar gelloedd annormal, profir y sampl am HPV yn gyntaf. Gan fod heintiad HPV risg uchel yn dod cyn i gelloedd annormal ddatblygu, mae profion sylfaenol HPV yn canfod pobl sydd mewn perygl o ddatblygu canser serfigol yn llawer cynharach. Os canfyddir HPV, caiff y sampl ei archwilio hefyd am newidiadau celloedd a'i ddilyn gan brofion pellach os oes newidiadau'n bresennol. Os nad oes celloedd annormal yn bresennol, gwahoddir yr unigolyn i'w sgrinio eto ymhen blwyddyn. Felly, mae'n bwysig cofio os nad oes gennych HPV, fod system wahanol ar gyfer y rhai y canfyddir eu bod yn wynebu mwy o risg. Os na cheir HPV risg uchel yn y sampl, gwahoddir yr unigolyn i'w sgrinio ymhen pum mlynedd. A bydd y newid yn y cyfnod rhwng apwyntiadau yn berthnasol i bobl y mae eu canlyniad sgrinio rheolaidd nesaf yn dangos nad oes ganddynt HPV risg uchel, a hynny am fod eu risg o ddatblygu canser ceg y groth o fewn y pum mlynedd ar ôl eu sgriniad yn isel iawn.