Meeting of the Parliament (Hybrid)

Meeting date: Wednesday, March 30, 2022

Official Report 992KB pdf

---

Ovarian Cancer Awareness Month

The final item of business is a members’ business debate on motion S6M-03472, in the name of Marie McNair, on ovarian cancer awareness month. The debate will be concluded without any question being put. I ask members who wish to speak in the debate to press their request-to-speak button now. I call Marie McNair to open the debate. Ms McNair is joining us remotely.

Motion debated,

That the Parliament acknowledges that March is Ovarian Cancer Awareness Month; understands that ovarian cancer is the sixth most common cancer faced by women in the UK, with over 600 new diagnoses in Scotland each year; notes that the symptoms of ovarian cancer are persistent and frequent, and that they usually happen more than 12 times a month; understands that key symptoms include persistent bloating, feeling full quickly or loss of appetite, pelvic or abdominal pain and urinary symptoms; further understands that there is currently no screening test available for ovarian cancer; highlights what it sees as the need for better public awareness; believes that a woman’s route to diagnosis is key to survival, and commends the organisations, campaigners and charities.

17:42  

I apologise for not being physically in the chamber, but I am currently self-isolating. It is a privilege to lead this members’ business debate on ovarian cancer awareness month. I thank all colleagues who have decided to speak in support, and I thank the minister for what I am sure will be a welcome and thoughtful contribution.

This month marks ovarian cancer awareness month. We know that ovarian cancer is the sixth most common cancer faced by women in the United Kingdom. According to Cancer Research UK, there are about 7,400 new cases of ovarian cancer each year, which equates to approximately 20 diagnoses per day. The key symptoms of ovarian cancer include persistent bloating, feeling full quickly, loss of appetite, pelvic or abdominal pain and urinary symptoms such as needing to urinate more frequently than usual. Other symptoms include unexplained weight loss, tiredness and changes to bowel habits or symptoms of irritable bowel syndrome, especially if it starts after the age of 50. Sadly, ovarian cancer is often diagnosed too late.

I am very aware of the suffering that this horrible cancer causes. I will never forget two women whom I had the privilege to care for when I was part of the nursing team at the St Margaret of Scotland Hospice in my constituency. The women were only in their late 20s and early 30s and, sadly, they both died of ovarian cancer. It was tragic to see those young women endure the misery that the cancer causes and the impact that it had on their families.

The majority of women will be diagnosed when they notice symptoms, typically when they visit their general practitioner. Although symptoms can occur at every stage of the disease, they are non-specific and can be hard to pinpoint. A woman’s route to diagnosis is key to their survival. As with many cancers, the earlier ovarian cancer is diagnosed the better the survival rate is. Put simply, the earlier the better. The difference in survival rate between early and late diagnosis is substantial. Statistics show that about 93 per cent of women who are diagnosed with ovarian cancer at the earliest stage survive for five years or more, compared to only 13 per cent of those diagnosed at stage 4.

In Scotland and in the UK more widely, we have an exceptional national health service screening programme that successfully helps to save many people’s lives. However, the programme covers only three main types of cancers and, overall, 6 per cent of cancer diagnoses happen through that route. We need to consider what can be done to better enhance all the options and see an even better approach.

In leading the debate, I am highlighting the need for early diagnosis. I am also sharing the experience of my constituent Denise Hooper and her ideas of what can be done to improve diagnosis. On behalf of Denise, I want to raise her belief that there is scope for testing for cancer antigen 125 in the detection and screening of ovarian cancer. Denise has campaigned on that for some time and previously raised a petition in the Parliament.

Denise was back and forth to her doctor for six months with IBS symptoms and was then sent for an ultrasound and MRI scan. She was given the all-clear and advised that the mass found was likely to be a fibroid but, due to her age, she was recommended for a hysterectomy. At Denise’s pre-operative assessment, her oncologist noticed that her levels of CA-125 were high during a blood test taken prior to that and informed her that that might have been an indication of ovarian cancer. Denise had her hysterectomy and was diagnosed with stage 3 ovarian cancer.

CA-125 is a protein that is often found on the surface of ovarian cancer cells and in some normal tissues. Women with ovarian cancer often have a high level of the protein in their blood. A small sample of blood is taken from the patient’s arm and sent to a lab for a simple test to measure the level of CA-125 in the blood sample. In most healthy women, the level of CA-125 is usually about 35 units per millilitre. However, some women can have a naturally high level of CA-125 in their blood. The level of CA-125 in a person’s blood can rise for many reasons, including endometriosis, menstruation, ovarian cysts and sometimes ovarian cancer, which is one reason why it cannot accurately be used as a sole screening test for ovarian cancer. However, we want its presence to lead to better screening as a matter of course.

If the level of CA-125 in a person’s blood is 35 units or higher, their GP should arrange for them to have an ultrasound scan of their tummy and pelvis. The ultrasound scan will create pictures of their ovaries so that they can checked for anything unusual and will help their GP to gather more information. In some areas of the UK, a CA-125 blood test and ultrasound scan are ordered at the same time. The National Institute for Health and Care Excellence recommends that women with possible symptoms of ovarian cancer be tested for CA-125 in a primary care setting, typically at their GP surgery.

Although the CA-125 test has been studied in women with secondary cancer, the test has not been fully evaluated for women who have seen their GP with symptoms that could be ovarian cancer. Cancer Research UK conducted a study that looked at 50,000 women who had seen their GP and taken the CA-125 test. Research found that 10 per cent of women with higher levels of the protein biomarker were diagnosed with ovarian cancer, making an abnormal test 12 times more predictive than previous estimates had suggested. As well as helping to diagnose ovarian cancer, CA-125 blood tests are sometimes used to monitor the treatment of ovarian cancer as well as other types of cancers such as fallopian, or to check for signs of reoccurrence.

Although the CA-125 test should be routine, it is not being suggested that it should be the be-all and end-all. Instead, Denise is asking that it be considered as part of the test in the routine screening for ovarian cancer. That would work alongside other screening methods that are often used to diagnose, such as ultrasound and transvaginal scans. It is clear that everything possible should be considered that has the potential to improve the detection of this horrible cancer.

As I said, I will never forget the misery that was inflicted on those young women whom I nursed at the end of life. We must pull out all the stops to increase awareness, have a step change in diagnosis and provide a gold standard in the necessary care of those with ovarian cancer.

I commend organisations such as Target Ovarian Cancer and many other campaigners and charities for their tireless efforts to raise awareness of ovarian cancer. I thank the other speakers for taking part in tonight’s debate. I thank my constituent Denise for sharing her story and for her bravery and determination to secure improvements in the efforts to diagnose as early as possible and therefore save lives.

I call Jackie Dunbar, who joins us remotely.

17:49  

Please accept my apologies for not being in the chamber this evening, Presiding Officer. I thank my colleague Marie McNair for bringing this important subject to the chamber for a members’ business debate.

Ovarian cancer is not my friend. I first met it back in August 1977 when I was nine years old. I did not know what it was at the time, but I knew that it was not good. Mam and Dad sat me down to tell me that I would need to go and live with my granny and granda for three weeks while mam went into hospital to get a small black spot removed from her belly. I know now that the explanation was not very factual but, at nine years old, it was good enough for me to get a grasp of.

Mam had her operation on 16 August 1977, the day that Elvis Presley died. My sister still remembers this, as Mam was a huge fan of his and it has always stuck in her mind. I came home after Mam got home from hospital to find Mam and Dad’s bed in the living room, and could not work out why. I thought, “Mam was getting better, wasn’t she?” After all, she had had the operation she needed. Eight weeks after her operation and 17 days after my 10th birthday, my mam passed away, aged just 34 years, from ovarian cancer. So, no, ovarian cancer is not my friend.

What do I know about it now? Well, I know that ovarian cancer is one of the most lethal of female cancers. I know that it is most often diagnosed at a late stage. The symptoms are commonly experienced as a result of other conditions, but people should let their doctor know how often they are experiencing symptoms, as that is an important step in helping the doctor to know when they should consider ovarian cancer as a possible cause. I know that, when it is detected at an early stage—when the cancer remains confined to the ovary—up to 90 per cent of those diagnosed are likely to survive for more than five years. That compares to 17 per cent surviving for five or more years when the cancer has spread to other parts of the body.

I also know that there is still no routine simple screening test to accurately detect ovarian cancer. Contrary to popular belief, cervical screening will not detect ovarian cancer. Although cervical screening is effective in early detection of cervical cancer, it is not a test for ovarian cancer. There have been no advances made in the last 40 years in the diagnosis or treatment of this silent cancer, and it is time that it got as much publicity as other cancers. That is why I am telling my, but more importantly, my mam’s story tonight.

We need a consistent approach to testing. Why does it have to rely on doctors taking the decision on whether someone fits the bill for testing? My sister used to get a CA-125 blood test done routinely, but I never have. Why? We both come from the same mother, but we have different doctors and different health authorities. I urge the minister to look into that as a matter of urgency.

I started my speech by saying that ovarian cancer is not my friend, and I am determined not to allow it to have the last say in my speech tonight. I dedicate this to my mam, Elizabeth May Dunbar, née Watt, wife to Jimmy and mam to Elaine, Andrew and Jacqueline, born 10 May 1943 and died 19 October 1977, aged just 34 years. You may be gone, Mam, but you are definitely not forgotten.

17:54  

I wish to draw members’ attention to my entry in the register of interests, as I am a practising NHS GP. I am not drawing this debate to a close, so I will not answer some of the questions that have come before me.

The ovaries are two small organs—each about the size and shape of an almond—located in the lower area of the tummy in the pelvis but, as with most things in the body, it is not the size that matters. They produce the eggs we need for babies. They also produce oestrogen and progesterone, which are the female hormones, and they are very busy organs. Ovarian cancer arises from the cells in and around the ovary and fallopian tubes, and those cells tend to spread on to the surface of the tummy and the transparent tissue that surrounds the organs around the abdomen. They form lumps on the surface of the bowels, the fatty tissue that extends down the stomach, the liver, the spleen and the lungs. Those lumps are metastases. They often produce excess fluid inside the tummy, which causes significant bloating and other uncomfortable symptoms.

That is what a patient of mine presented with when she came to the surgery. She was a young woman in her 20s who was complaining of random bloating and feeling uncomfortably full really quickly after eating. Those could be symptoms of anything, including irritable bowel syndrome. Fortuitously, I had been reading about ovarian cancer that very morning, so that was the first thing that came to my mind and I added a CA-125 blood test to the checks. Unfortunately, the CA-125 level that came back was very raised.

We have all heard about CA-125 from previous speakers, so I will not continue with that, but when the test came back positive I organised urgent ultrasound and referral to gynaecology. Members might think that it was very fortunate that the woman had received a possible diagnosis after just one visit to the GP when most women have to present repeatedly, but that was not to be. She died because she had put up with her symptoms for too long. The feeling of being full too quickly, loss of appetite, bloating, going to the toilet more, tiredness, weight loss and change of bowel habits are all ovarian cancer symptoms, and she felt embarrassed to seek help. The cancer had spread and that is what caused her to die.

We have heard that, each year, 7,400 women in the UK and 600 in Scotland are diagnosed with ovarian cancer, which is very difficult to detect because of the vague symptoms. If you are worried, do not hesitate. If you have the symptoms that I have spoken about, you need to go and see your GP. You need to ask for help, and please keep a symptom diary, because that is really helpful for me when I see it.

We do not have a screening test for cervical cancer but, for women and people with a cervix, we have a cervical screening test for the human papillomavirus, HPV. It is very important, as HPV causes 99 per cent of all cervical cancers and four out of five Scots will have HPV at some point in their lives. We can check for it with the screening and also with the smear test. If you have not had your smear in the past five years, please book with your GP today. I digress from ovarian cancer but, as it is a women’s health issue, I thought that I would take the opportunity as a doctor to encourage women to get their smears as well.

It is very clear that early diagnosis and timely intervention lead to better outcomes and save lives. If you have any new symptoms or if you are worried, please do not delay. Please come forward. It could well save your life.

17:58  

I thank my colleague Marie McNair for securing this important debate. Despite a welcome decrease in its incidence, one in 59 women in Scotland are still diagnosed with ovarian cancer, and there is a striking lack of awareness of the disease. That is why I would like to start by paying a warm and heartfelt tribute to Janey Godley, who is currently undergoing treatment for ovarian cancer while openly and admirably sharing her experiences on social media. Janey has done a huge amount to raise awareness as well as offering comfort to others. She is an inspiration and I wish her all the very best with her on-going treatment. As Janey says, it is a sneaky cancer. Symptoms can be complex and misdiagnosed as other less serious conditions—some of the symptoms have already been discussed this evening.

In recent years, Scotland has led the UK in improving early diagnosis of ovarian cancer, having the shortest diagnostic pathway with the CA-125 blood test and ultrasound carried out at the same time, but there is no one viable screening tool. We need to focus on finding an effective screening tool and raise further awareness of the disease, as the earlier the diagnosis, the better the prognosis.

One person who knows the importance of early diagnosis is my Stirling constituent Gillian McLaren. As a keen netball player with an active lifestyle and healthy eating habits, at the age of 33 Gillian felt at low risk from cancer. She visited doctors for over 18 months with bowel changes, exhaustion, nausea, pain and symptoms of urinary infections. In early 2020, a blood test showed raised levels of CA-125 and she was diagnosed with ovarian cancer. Gillian said that there is nothing that prepares you for the words that you have cancer. She said:

“I was told in a very gentle and sensitive way but it is still a shock. I had always hoped that one day I would have a family of my own. I was told I would lose my fertility during treatment. Cancer was threatening my life but it was also taking away my choice to one day have children. That fertility loss felt like a death.”

Now aged 35, Gillian wants to raise awareness of the signs of ovarian cancer, especially in younger women, and help other young people with the disease feel less isolated. Gillian’s advanced diagnosis was life changing and affected her prognosis but, thankfully, her surgery was a success and she is grateful to be in remission now. In Gillian’s own words:

“I believe it is not that it is a silent killer. It is a lack of knowledge of what to look out for among the public and health professionals. It is about adding up the various symptoms with a potential ovarian cancer diagnosis. It is really important to listen to women when they say they know their bodies. This should really be respected and heard.”

Crucially, Gillian says:

“If anyone you know is experiencing symptoms that are abnormal or unusual, head straight to your GP. Be as persistent with them as your symptoms are with you.”

I would like to thank Gillian and my colleague Jackie Dunbar for sharing their very personal experiences with us today. Only by continuing to have these very open, public conversations can we work to raise awareness and tackle ovarian cancer together.

18:02  

I thank Marie McNair for bringing this important debate to the chamber and I thank members for the contributions so far. We can see how important these debates are, as Evelyn Tweed has just said, in allowing us to talk about these issues in a public forum. On behalf of Scottish Labour, I recognise the importance of ovarian cancer awareness month, which is marked in March. This is a cancer that impacts over 600 people in Scotland every year and this is an important debate in which we seek to raise awareness about it.

I would highlight the symptoms again, but I think that they have been covered very well by the previous speakers. The key fact is that it is important that women go and seek help should they have any of those symptoms and not feel that they are bothering any of the medics or the nursing staff. I am sure that those staff would rather that women came forward and made sure that they were getting themselves checked.

As the motion states, the symptoms usually occur frequently, which is defined as happening more than 12 times a month. It is important that women come forward. The symptoms of ovarian cancer are very common and can be caused by many conditions, but it is important to have them checked out by a GP because, as we have learned more and more in recent years, the earlier an individual has cancer of any sort diagnosed, the more likely they are to be treated and to recover.

As is mentioned in the motion, despite significant research efforts and trials, there is currently no screening available for ovarian cancer. I was very interested in the contributions in the debate so far, because I am not overly familiar with that issue, and I certainly will seek to find out a lot more about the points that Marie McNair and others made.

To take more preventative measures, obtain quicker rates of detection and better levels of treatment, it is crucial that we invest further in research, because knowledge is power. The more we can understand, the better chance we have of achieving Ovarian Cancer Action’s aims of making this a more survivable cancer. That is also why raising public awareness is so important. When regular screening services do not exist as they do with other potential cancers, it is vital that members of the public are encouraged to be conscientious in checking for symptoms and to act accordingly and promptly to ensure that they are working in their own best interests.

According to Ovarian Cancer Action,

“Although five-year survival rates for ovarian cancer are improving, other cancers, such as breast cancer, had better survival rates two generations ago than ovarian cancer does today.”

I thought that that was quite striking. This should be a concern to us all. It is a staggering truth and it shows that, although we have made progress, there is still a long way to go to ensure that there is better treatment—ideally, personalised treatment—and higher survival rates for women.

On behalf of Scottish Labour, I again recognise the significance of ovarian cancer awareness month and stress the importance of not stopping our efforts to raise awareness, as we do so often in the chamber, but to regularly bring to the attention of our constituents the symptoms of the illnesses and the fact that they are treatable with early detection. Progress has been made, which is testament to the work of campaigners and organisers who have done a significant amount of work to raise awareness of ovarian cancer, but we must not stop. We must keep making more progress, invest more in research and deliver early diagnosis and improved treatment. I thank everyone for their contributions. Thank you very much.

18:06  

I thank Marie McNair for bringing the debate to the chamber. As the motion states,

“ovarian cancer is the sixth most common cancer faced by”

people with ovaries

“in the UK”.

It is important that we highlight the symptoms and causes of cancer, so that everyone knows what to look out for. That is particularly important for ovarian cancer. As we have heard, symptoms can be difficult to recognise, particularly in the early stages, because they are so often the same as symptoms of other conditions such as IBS. The earlier ovarian cancer is diagnosed, the better the outcome. When it is diagnosed at its earliest stage, 98 per cent of people with ovarian cancer survive the disease for one year or more, and 93 per cent survive for five years or more.

However, according to Ovarian Cancer Action, 90 per cent of women and people with ovaries cannot identify the main symptoms. Cancer is a worrying subject and can be difficult to talk about, but, in order to raise awareness, we need to have those difficult conversations. If someone we know is experiencing symptoms of ovarian cancer, they might not identify those symptoms as signs of cancer, or they might be worried about going to their GP when they are so busy. We all have a role to play in raising awareness of the symptoms and encouraging people to seek help when they experience them. Starting a conversation with someone about cancer can seem daunting, but it might save a life.

It is also important to raise awareness of risk factors so that people can determine their level of risk. Between 5 and 15 per cent of ovarian cancers are caused by an inherited gene. Someone whose mother or sister had ovarian cancer is about three times more at risk. The risk of ovarian cancer also increases with age, with most cases occurring in people with ovaries who are over 50 years of age. However, as Jackie Dunbar said, the cancer does not discriminate by age. Other risk factors include certain medical conditions such as endometriosis, and hormonal factors such as starting periods young or having a later menopause. I encourage anyone who has concerns to visit the NHS Inform website, where more information about risk factors can be found. The Macmillan Cancer Support website can also offer helpful information and advice.

It is worth noting that, unlike with cervical, bowel and breast cancers, there is still no reliable and effective screening method for ovarian cancer. That is why it is so important that people are aware of the signs and risk factors. GP practices are open and are seeing patients, so if you have persistent concerning symptoms, please seek medical advice. Ovarian Cancer Action recommends that people with concerning symptoms keep a record of what they are experiencing and have their notes to hand when they speak to a doctor.

As we have heard, the 62-day cancer referral standard is not currently being met by any health board, and performance against that standard has worsened since December 2020. That is concerning, and the pandemic has obviously had an impact. Staff are working extremely hard to work through the backlog, and we need to ensure that they have the support to continue to do so.

I am aware that the Scottish Government has set out plans to address workforce issues in the national workforce strategy and the NHS recovery plan, but we need to make sure that we retain staff across the NHS, particularly in nursing. We need to ensure that there is a joined-up, integrated workforce so that we do not simply move existing staff from one service to another.

Given that this is ovarian cancer awareness month, it is worth ending my speech by reiterating the main symptoms of ovarian cancer: increased abdominal size and persistent bloating; persistent pelvic and abdominal pain; and difficulty eating and feeling full quickly or feeling nauseous. If you experience those symptoms regularly, please make an appointment with your GP. Women’s pain is not always taken seriously, but you know your body better than anyone. If something does not feel right, please seek help.

18:11  

I thank Marie McNair for lodging the motion and securing the debate, and my colleagues for their important contributions. It is a brilliant opportunity to reflect on what we have achieved so far and on further opportunities to improve.

I particularly commend Jackie Dunbar’s very moving speech, in which she gave her child’s eye view of the experience of her mum being diagnosed and dying so rapidly with ovarian cancer. It is vital that each and every one of us uses our life experience to improve current treatments and work for our constituents, so I am very grateful for that moving contribution.

Unfortunately, ovarian cancer continues to be prevalent throughout Scotland and the rest of the United Kingdom, with about 600 women being diagnosed every year in Scotland. We know that the earlier cancer is detected, the easier it is to treat. Raising awareness of ovarian cancer and its common symptoms, which have been outlined by members, is crucial in detecting the cancer early, particularly because the symptoms can be vague, as many members have said.

The Scottish Government is committed to detecting and treating cancer as early as possible. Raising awareness of the symptoms of cancer, including ovarian cancer, is a focus of our £44 million detect cancer early programme. As services continue to recover from the impact of the Covid-19 pandemic, we recognise that our efforts in that area have never been more important. That is why we have committed an additional £20 million for the DCE programme as part of our NHS recovery plan, which was published in August 2021. That funding will lead to even greater public awareness of the signs and symptoms of cancer, and it will support the development of optimal cancer pathways to improve earlier diagnosis rates. Traditionally, the focus has been on bowel, breast and lung cancers, but other areas have been added more recently to the programme.

We are working on a number of awareness-raising initiatives through the programme. That includes redesigning the DCE website, which is available at getcheckedearly.org. The website will feature an updated version of our symptom checker tool, which is complete with links to relevant third sector organisations. The online checker tool was first launched in 2018, and it includes information on symptoms of ovarian cancer. In addition, research is being undertaken to better understand the possible barriers and levers to early diagnosis, on which any new DCE campaigns should focus. Once the results are available, we will seek new solutions to improve access.

We recently formed a new early cancer diagnosis programme board, which is chaired by Catherine Calderwood, the national clinical director at the centre for sustainable delivery. That group will be responsible for shaping and supporting the delivery of Scotland’s early diagnosis agenda over the coming years, including the development of any new and additional public awareness campaigns. In recognition of the importance of primary care clinicians in finding cancer early, a clinical review of the Scottish referral guidelines for suspected cancer was completed, and updated guidelines were launched in early 2019. Those include guidelines for suspected ovarian cancer.

In relation to other engagement, we are in regular contact with Target Ovarian Cancer, which is a valued member of the Scottish Cancer Coalition. I was very pleased to become a teal hero by participating in Target Ovarian Cancer’s event to promote ovarian cancer awareness month at the Scottish Parliament a few weeks ago. My officials and I continue to liaise with the charity on its work to raise awareness of ovarian cancer.

Over the course of the pandemic, urgent suspicion of cancer referral rates fell below pre-Covid levels. Public awareness campaigns and messaging have run throughout the pandemic in order to increase uptake and encourage people with possible cancer symptoms to seek help. I encourage any individual who might be experiencing common symptoms of ovarian cancer to present to their GP.

Not only is it important for people with symptoms to come forward, but it is equally important to be aware of the risk factors in developing ovarian cancer. According to Target Ovarian Cancer, two of the main risk factors are age and genetic factors. Age is the primary risk factor, with risk increasing as a woman ages. The majority of diagnoses are for women over the age of 50. In addition, 15 to 20 per cent of cases are linked to mutated genes—primarily BRCA1 or BRCA2. Other risk factors include being overweight, using hormone replacement therapy and having endometriosis, which can marginally increase an individual’s risk. However, it is important to note that those factors do not always result in developing cancer.

More generally, women’s health is a key priority for the Government. That is why, last August, Scotland became the first country in the UK to publish a women’s health plan. That represented an exciting step forward in our ambitious aim to raise awareness of women’s health, to improve access to health information and services for women and girls and to reduce inequalities in health outcomes for all women. The plan focuses on a specific set of priorities where there is evidence of inequalities and where women have told us that improvements are needed. Those priorities include menstrual health, menopause and endometriosis care.

Alongside that work, the Scottish Government works closely with a number of organisations, including Target Ovarian Cancer and the Scottish Cancer Coalition, which have been mentioned, to raise awareness of ovarian cancer. Our partners are key contributors in raising awareness and providing support for people suffering from or at risk of ovarian cancer. They also provide assistance, education and information to those who need it most. Their work is invaluable, and I take this opportunity to acknowledge and thank all those involved.

I am glad that Evelyn Tweed mentioned Janey Godley, who is undergoing treatment for stage 3 ovarian cancer. In sharing her experience, even at this really tough time for her and her family, she is doing a power of good by raising awareness of this devastating condition. As public health minister, I am very grateful for that. I am sure that all of us in the chamber wish her well in her recovery.

It is appropriate to acknowledge the continued hard work of our health workers, who have, in the face of a pandemic, continued to provide high-quality care and support to all the people who have a suspicion of cancer.

As we have heard, the Scottish Government and all of us here are absolutely committed to increasing awareness of ovarian cancer and improving cancer patients’ experiences and outcomes. I thank all our partners that help us in achieving those goals. We will continue to work together to further improve our services and awareness.

Meeting closed at 18:18.