 The final item of business is members' business debate on motion 15194, in the name of Monica Lennon, on cervical screening update statistics. This debate will be concluded without any questions being put, and I would ask those who wish to speak in the debate to press the request-to-speak buttons. Call on Monica Lennon to open the debate for around seven minutes, please. Thank you, Presiding Officer. This is cervical cancer prevention week, and I am grateful to members who supported my motion to allow this debate to take place. There is actually a lot to be positive about when it comes to cancer of the cervix. Why? Well, it can largely be prevented through the HPV vaccination given to girls and soon boys in Scotland, and through cervical screening, also known as a smear test. Tonight, with thanks to the fantastic campaigning and research led by Jo's cervical cancer trust, we are going to talk about cervical screening, and I hope that we can focus on what more we can do in Scotland to make cervical cancer a disease of the past. This debate is critical because not enough women are attending their smear test. An issue that I know the minutes of our public health is taking very seriously. Let's face it, no one likes having a smear test. Like too many women in Scotland, I myself have ignored reminder letters and missed my smear test in the past. It can be uncomfortable, and many of us feel embarrassed to talk about it. Never mind, go to the appointment. The latest round of statistics reveal that the number of women not attending their regular screening is increasing. In fact, we are at an all-time low. Despite our nationwide cervical screening programme offered to women between the ages of 25 and 64, around one in four women do not attend their regular appointments. The uptake is even lower among younger women, despite the fact that cervical cancer is the most common cancer for women under the age of 35. Only 62 per cent of women aged between 25 and 29 attend their regular appointments. Yet not attending smear test appointments is one of the biggest risk factors for developing cervical cancer. According to new research by Jo's Trust, young women do not go for their smear test because they feel embarrassed or they feel scared or they feel vulnerable. Eight out of ten admit that they are embarrassed. Difficult in getting a suitable appointment time or time off work are also factors. We have to remove the fear of the unknown and the worry about smear tests. Hashtag smear for smear is seeing high-profile celebrities, campaigners and even politicians sharing a lipstick-smared selfie this week. After I shared mine on Twitter yesterday, a close friend said to me that this was just what I looked like on a normal night out. I claim that I strongly reject. The WhatsApp discussion with my girlfriend that followed from that remark proved to me that it is good for women to talk about their health years with one another and perhaps a little bit of light-hearted humour can help with that. Katie Johnson from BBC The Social recently filmed her own experience of going for a smear test. As Katie says in the video, realistically this is two minutes of your life. A little bit of awkwardness, sure, embarrassment, but it could stop cells in their tracks before they become cancer. Katie, who has endometriosis, got over her initial fear of the test. Katie, who has endometriosis, got over her initial fear of the test, but we have to recognise that it's not an easy procedure for all women. The My Body Back project, based at the Sandiford Clinic in Glasgow, provides a dedicated smear testing service for women who have experienced sexual violence. There are so many lessons to be learned from that project. We do need vital trauma-informed services as standard across the country. George Trust told me about Nicola, who is from Scotland. She was diagnosed with cervical cancer in 2015. Let Nicola's words sink in. I was diagnosed with stage 1b2 cervical cancer at age 35 after putting off my smear test for over a year. It was six weeks before I was due to get married overseas. I was devastated. The word cancer seemed to take over my whole life and the thought that I might not be around to see my two children grow up terrified me. I postponed my treatment for a few weeks until after my wedding because I thought if something were to go wrong that at least I could leave my husband, children and family with wonderful memories of our wedding and holiday together, our radical has direct to me means that I can no longer have children and I went into early menopause. The physical and psychological impact of cancer will never go away, but I look forward to the day that no one is diagnosed with cervical cancer. What can we do to get the word out that cervical cancer can be prevented so that other women in Scotland do not have the same experience as Nicola? Firstly, the Scottish Government and George Trust deserve enormous credit for previous initiatives that the Nippet in the Buds campaign ran last year. That is exactly the type of awareness work that we need more of. The HPV vaccination programme also deserves massive credit. George Trust has been calling for Scotland to continue to lead the way by running a pilot of self-sampling, which could have a hugely positive effect on the levels of screening. I was pleased to read reporters today that the NHS in Scotland will pilot a scheme of self-sampling for women who have routinely not kept their regular appointment and I look forward to seeing its results. More could also be done by health boards to monitor GP practices with a low uptake and to increase availability of screening appointments. Samantha, who is one of my constituents in Hamilton, waited over two months for an appointment. Clearly that is not acceptable. Another wise woman, Leslie from Edinburgh, had this to say. Imagine that we did not get smear tests under the NHS. We would all be campaigning to get them for free. It is literally a few minutes at the nurse who has probably seen a lot worse than your lady garden and so it is important and life-saving. Then there is a novel initiative by a Glasgow beauty salon where Debbie Porter is offering free waxing services to women to encourage them to book their smear tests. As supported on Glasgow Live recently, Debbie posted on Facebook to her clients, being a wax specialist, I see many of you girls who admit that you have not been for a smear or are too scared to do so, yet you have me wax you for 20 minutes. I think that Debbie has a point. In conclusion, there are many, many reasons why women put off their smear tests, but there is one overriding reason why they should not. The tests protect against cervical cancer and can save lives. I thank all the women who have shared their experiences and thoughts with me and, of course, George Truston. We have a number of volunteers and board members in the gallery tonight for all the amazing work that they do. If we match our shared ambition with action, we can consign cervical cancer to the history books. We move now to the open debate. Speeches of four minutes, please. Emma Harper, followed by Miles Briggs. I would first like to congratulate Monica Lennon on bringing this important debate to chamber today. It gives us the opportunity to raise awareness of the latest cervical cancer screening update statistics. Given that cervical cancer prevention week runs this week from 21 January to 27 January, it is quite timely that we have the opportunity to raise awareness about this extremely important subject this evening. I would like to remind chamber of my background as a registered nurse, where much of my experience was working in the operating room to support gynaecologists in their work following positive results, which required less invasive action compared to the more invasive surgery that is required for women who did not attend for screening at all. Presiding Officer, as outlined in the motion, the latest statistics show cervical screening rates are falling in Scotland and all women aged from 25 to 64 are invited for cervical screening. That is for every three years between 25 to age 49 and then every five years from age 50 to 64. I was shocked to read that one in four women are not taking up their invitation. That is, as we know, a relatively simple test. Indeed, approximately 6,000 women across Dumfries and Galloway in my south Scotland region have not responded to their invitation to attend their GP surgery, practice nurse or sexual health clinic. It is important to acknowledge that cervical screening is the best protection against cervical cancer and that attendance for screening appointments mean that there will be increased diagnosis, and, as with many diseases and conditions, early diagnosis is absolutely key to effective early treatment. Presiding Officer, I would like to use my time that I have to highlight some of the unique work that is being developed by my former medical colleagues, including researchers in NHS Dumfries and Galloway, doctors Heather Currie and Dr William Forson, Dr Gwen Baxter and Dr Jim Lawrence, whom I met with last year to discuss their proposal for the research for the self-testing of cervical screening. As recently as last Friday, I caught up with Dr Forson for an update, and I am pleased that the self-test pilot scheme has now gained approval by the Ethics Committee and will roll out soon across NHS Dumfries and Galloway. The team mentioned above has developed the self-test swab sample to be gathered, which meets the required criteria for testing for the human papillomavirus. The unique swab sample, and I know that I would not like to have props, but I have a unique swab sample packet right here with me that shows that it is a wee cotton bud type swab and PCR media solution. The goal is for the current process to be followed, so instead of having cytology samples being done, the HPV cotton bud may be done, and that would be replicated in current places for obtaining cell samples. Ultimately, the research is to offer the non-attenders—those 6,000 non-attenders known as defaulters—to attend and provide the opportunity to self-test in their own home. The self-test swab kit costs less than £2. Research has shown that the self-test kit, which is proven to work in other study populations—one that I know of in Africa, but in Canada as well, and it has been tested in the Netherlands—could be applied here in Scotland to help attract the non-attenders to take up cervical screening and, simultaneously, work to address the barriers to attending such as cold speculums exposure and discomfort and embarrassment and lack of knowledge even. Often the challenges are work-life constraints and even including transport to and from work-home to places for sampling to be obtained. Women really can be quite challenged when they are finding the time to get to their appointments and I am one of them. I have been a defaulter, but I am now taking proactive steps to get myself to my nurse practitioner. I am also aware that some health professionals across Scotland are a bit put off because they often know their colleagues and friends who carry out the screening. Other countries, as I have mentioned, in the Netherlands, are trying the self-testing approach, which I am looking forward to hearing the results about. I would therefore encourage the Scottish Government to closely explore and engage in the outcomes of the self-test research and, if it works, to look at options of a self-test screen kit to be rolled out across the whole of Scotland. Servical cancer is the most common cancer in women aged 25 to 35 in Scotland and the rest of the UK. Around six women every week in Scotland are diagnosed with cervical cancer. The screening saves around 5,000 lives every year in the UK and prevents eight out of 10 cervical cancers from developing or spreading. It is so crucial to encourage women to attend and be screened and I am also aware of the innovative work from various businesses across Scotland. Monica Lennon has mentioned one. There is also one in Dumfries called Belisimo Salon who offer women money for waxing off for treatments so that they can then go and have their cervical screening tests. I would encourage everyone to take up their offer when they are invited for their cervical screening. Miles Briggs, followed by Elaine Smith. I would like to start by congratulating and thanking Monica Lennon for bringing forward this debate on an important issue of screening uptake for cervical cancer. I would also like to take this opportunity to thank the organisations, including Joe's cervical cancer trust, for the briefings that they have provided us all ahead of this debate. The reason that cervical cancer screening rates are so important is because it saves lives, has been outlined, preventing eight out of 10 cervical cancers from developing. I hope that today, collectively, we can send out a message that screening saves lives and can save hundreds of Scottish women's lives every year if they go to their screening. In Scotland, approximately six women are diagnosed with cervical cancer every week, six women every week. The numbers and the potential to reduce that is really if we can have uptake increase around screening and increase that uptake. Cervical screening is lowest among younger women as it has been outlined already, which is particularly concerning for many of us, as cervical cancer is most common in women under the age of 35 in Scotland and across the UK. A survey carried out by Joe's cancer trust asked 2005 women aged between 25 and 35 about why they would delay or not go for a screening test. The results, as we have heard already, found that a lot of it was about embarrassment and young women who delay or do not go for screening tests. 71 per cent actually felt scared, 75 per cent felt vulnerable, 81 per cent said that they were embarrassed, and 67 per cent responded that they felt that they had no control over the screening and the test. The survey, I think, was incredibly important for finding out from women what they would make them delay or not take up the invitation for a test. 27 per cent said that they were concerned about making a fuss, 18 per cent afraid of being judged and 18 per cent thinking that their concerns were too small or silly to go for the screening. Almost half of the women surveyed said that they regularly delayed or did not take up the invitation of a test. If uptake of screening is going to be improved and the concerns of women who have been outlined are going to be addressed, we need to see progress. I really do welcome—this week, again, it is great for us to have this debate—that Joe's Cancer Trust has launched their smear for smear social media campaign to raise awareness of what a smear test is for and why it is important and provides support and advice to women who are going for a test to make it feel less daunting. As well as providing support and advice on the campaign, the campaign aims to act as a reminder to women to book their test if they are put off or are being meaning to do. In busy lives, people often put those things off, but it is something that we should look to change. I think that men also have a role to play in this. Ali Maxwell, the son of Joe Maxwell, who the charity is named after, has said that men should play a role in understanding the importance of tests and encouraging our mothers, daughters, sisters, partners and friends to go and take the test. That is something that, too often, we have debates where we are encouraging women to remind men, but it is an opportunity to show how men can play a role in helping to address some of the fears around smears. The survey revealed that 72 per cent of women delayed or missed the test because of embarrassment. As has been mentioned, a stranger is examining intimate areas and 44 per cent is not knowing how to talk to a stranger about that. It is important that such public information campaigns are able to tackle those issues. As has already been outlined, many people who work in the health professionals feel that they might go and see other health professionals, so how we can look towards reassuring people is important. The cross-party group on cancer last week published our inquiry into the Scottish Government's cancer strategy and highlighted some progress. I think that one area in which we did see progress in public information campaign was about the flower campaign. I hope that the Government looks to repeat that in the future. However, we still face significant challenges around cervical cancer, with incidence rates increasing by 19.1 per cent over the past decade. In closing, I would like to hear from ministers this evening what work has been undertaken to develop reminders for women to further look towards how we can use technology around screening reminders, such as email and automated text messaging on top of the letter that is received from their local health board. Finally, to conclude, I think that we should all look to address the barriers that are stopping women from accessing screening. Campaigns such as Smear for Smear can make a huge difference in improving uptake rates for cervical screening and reduce the number of women in Scotland and across the UK who are diagnosed with cancer every year. I am grateful to Monica Lennon for bringing this matter to the chamber during Cervical Cancer Prevention week. I believe that there is some discussion about how to pronounce it, but I am sticking with the west coast way. However, we pronounce it for women's health that women take up the invitation to go for a cervical smear test, so it is worrying that the numbers are doing so are in decline. That needs to be addressed as a priority. It may need another Government public health campaign to try and raise awareness of the benefits of the smear test and provide reassurance. As we know, there is currently a charity campaign running by Joe's Cervical Trust. That UK-wide charity was set up by James Maxwell in memory of his wife, Joe, who died from cervical cancer. It provides high-quality information and support to help to prevent cancer and reduce the impact for those who are affected, both by cervical cancer and abnormalities, and campaigns for excellence in treatment and prevention. Last year, the B-Servix Savvy road show toured the country, and it provided information and support about screening and cancer to local communities, including in Scotland. The purpose of that road show was to ensure that more people know what cervical screening is, what to expect at the test and the role of it in preventing cancer, learn about cancer and how to spot the symptoms and find out who can have the HPV vaccine and why. I visited the road show bus last year when it was in Cote Bridge, and it was kept very busy with lots of women and some men accompanying them to find out more. As we have had some discussion of, as the women in the chamber will know, it is more often the fear of the smear test and the possible bad result, rather than necessarily a negative experience with the test itself that can stop women from attending. Although the test is certainly not comfortable, it should not be painful, and I think that making sure that women know this is important and encouraging them to attend their appointments. Discussing the outcomes of a bad result is received as crucial and particularly focusing on the excellent chances of treating cervical cancer if it is caught quickly. That is something that Monica Lennon pointed out in her opening speech. Droservical trusts can help with information and advice about the test. They give useful tips like ensuring that it is a woman, doctor or nurse that you see if that makes you feel more comfortable about going for the test. I have to say that my own personal experience is the only time that I did have a bad experience with the test when I was quite young. It was a male doctor, and so personally I would always try and ensure that it was a female doctor or nurse that I was seeing. They also highlight the particular issues that women who are survivors of sexual abuse might have with screening and they provide specific advice and support, and a further area of the website provides helpful advice for women with learning disabilities. The current campaign by the trust is underpinned by new research, which, as we have heard, shows that young women who delay or do not attend can feel scared, vulnerable and embarrassed at the thought of going. Two thirds said that they would not feel in control during the test, so it is important to show them ways that they can be in control. I think that addressing those issues would no doubt help to boost the screening numbers. The idea of invasive screening can be particularly off-putting for young women, and more research into ways to conduct less invasive screening would be extremely welcome. I was very interested to listen to Emma Harper's contribution on some of the research that has taken place, some of the new research, into the issue of screening, certainly. Thank you for taking that intervention. You mentioned people who had been on the receiving end of sexual violence. Do you think that a self-test approach might be a way to support women in that experience? Thank you, Presiding Officer. I think that it certainly could be an option. I think that all ways—my own views on it would be that whatever makes women feel comfortable to take the test should be explored. All options for that should be explored until we try and accommodate ways that everyone can feel comfortable. We have to look at ways that out of hours provision can be given, and employers are more sympathetic to letting women have time-off work to go for the tests. Closing, Presiding Officer, because I noticed them over my time, I mentioned an issue that I do not believe is given enough thought or action to tackle it. That issue is that for many women who are homeless, living on our streets or in hostile accommodation or in women's refuges, then the opportunity to get health screening, for example, for breast cancer screening or cervical smear tests, is not available to them. They do not receive letters of appointment, they might not have a GP or they have no idea how to go about getting screening and all probability. It might seem like the least of their worries, but it is something as a society that we should all be concerned about. I would be interested in the minister's comments on how that particular issue could be addressed going forward. Once again, I thank Monica Lennon for bringing this important women's health issue to the chamber. I thank you for the bit of extra time. Alison Johnstone, followed by Rona Mackay. I thank Monica Lennon for bringing this important issue to the chamber tonight during cervical cancer prevention week. It is fair to say that we all agree on the importance of getting regular health checks, and cervical cancer is no different. We are aware that the uptake of screenings or the smear test has fallen dramatically across Scotland in recent years. Around 73 per cent of women in Scotland currently access screening, but that is consistently lower than uptake levels in Northern Ireland and Wales, which is a little higher at around 77 per cent. I was really concerned to note that Lothian region has the second lowest uptake rate in the country. As Miles Briggs noted, the rates are closely linked to age, but they are also linked to socioeconomic factors too. Young women have the lowest levels of uptake, and uptake is particularly low among women living in areas of greatest deprivation. Increasing levels of uptake across all backgrounds, across all regions is vital, because cervical screening saves around 5,000 lives a year and prevents up to eight out of 10 cervical cancers. Research by Jo's Cervical Cancer Trust reveals some of the issues that have been affecting uptake. The availability of GP appointments can vary widely between different areas. Almost one in 10 women were only offered times that they could not make when they last tried to book an appointment, with around seven of those questioned by the trust being told that no appointments were available when they called for a screening. Sometimes you put it off at that moment and then you never get around to making that appointment again. The demands of the workplace, too, are a barrier for many women, with a fifth finding it a struggle to fit an appointment time around their job. Over a tenth of those surveyed by Jo's Trust said that they would be more likely to book an appointment if they did not need to use annual leave from work to do so. Another barrier is the decline of screenings at sexual health centres. A higher than average number of abnormal results come from tests taken at those clinics, so they have great importance to ensuring that worrying changes are noticed at the earliest opportunity. In Scotland, provision of screenings at sexual health clinics varies widely. In Forth Valley in 2017, only five tests were taken, while over 4,000 screenings took place in Greater Glasgow and Clyde. A huge difference there. Mobility is another barrier faced by women, particularly for those who are housebound. Getting a GP to visit for a screening is not always possible. Emma Harper's contribution on a potential pilot is something that I would warmly welcome. As Elaine Smith touched on, the thought of attending a screening can be particularly difficult or traumatic for women who have experienced sexual violence. The procedure for having to discuss the process with a GP can be a really challenging barrier to overcome. I would like to highlight to members specialist clinics such as my body-back project in Glasgow and urge that additional funding is available for those oversubscribed services. Having accessible information on cervical screenings in a range of languages is also vital. We really need to get smarter with how we communicate with women about attending regular screenings. The more women-focused and responsive appointment systems can be, the better chance they will have of reversing the decline in uptake. Nationwide text or email campaigns could reach new audiences. Indeed, reminders to attend a screening have been popping up on Twitter timelines. More innovation like this is needed, especially as there are gaps in the data with gaps available on who is not attending. Better data, for example, collecting HBV vaccination status alongside SME results would allow for more targeted activity, saving money and resources in the long term. On to that call for self-sampling pilots, better data systems could improve the reliability of results here, too, and overcome some of the barriers around getting the time to attend a surgery. 80 per cent of women surveyed by Joe's trust said that they would prefer to do an alternative screening at home, and that is rising to 8 per cent among those who have put off getting an appointment. It can empower those women who have experienced sexual violence to take the test into their own hands. I would like to say that we also need to look at how we might incentivise GPs to help to boost uptake rates. We know that some actions that GPs take are incentivising, and we need to look at that. It is fair to say that there is much that can be done to address the decline, and we need to get better at collecting data. We need to fully understand why someone would struggle to attend and why they are loath to do so. I think that developing the reliability of that self-test at home should also be prioritised in the meantime as a way to help the most vulnerable women. Rona Mackay, followed by Annie Wells. Can I add my thanks to Monica Lennon for bringing this important debate to the chamber? The speeches that we have heard today drive home just how vital it is to highlight the issue, and I think that there has been some fantastic points raised right across the chamber. Cervaigal cancer is the 14th most common cancer in females in the UK, accounting for around 2 per cent of all new cancer cases. Almost all cases of cervical cancer are caused by a common virus called human papillomavirus, HPV. Cervaigal cancer screening is a great NHS success story. It has been available all my adult life and can pick up any abnormalities at an early stage, which leads to painless treatment to preventing cancer. All women from the age of 25 to 65 are invited to attend cervical screening, and I can honestly say that I do not think that I have ever missed receiving a reminder. So this system works. It saves 5,000 women's lives a year throughout the UK. In 2017-18, 3,782 cervical screening tests were processed in Scotland. Of course, for the past 10 years, the HPV vaccine has been offered to girls from S1 to S3 in Scottish secondary schools, a fantastic public health initiative. The immunisation helps protect against the types of HPV that cost 75 per cent of the cases of cervical cancer. Alarmingly, as we have heard, according to the report by Jo's Cervical Cancer Trust, 72.8 per cent of eligible women in Scotland aged 25 to 64 were recorded as being screened, and just 56 per cent of young women attended in Glasgow. It is the most common cancer in women aged 25 to 35 years of age in Scotland. Research shows as we have heard that most do not attend because they are scared or embarrassed. So we must reach out to young people to stress how important it is to do this test. The test is to prevent not find cancer. I agree totally with Monica Lennon on trauma informed screening with Emma Harper on the self-test screening. That is really, really positive news. Yes, it can be uncomfortable, but it takes less than two minutes, and that two minutes may be the most important two minutes that you will spend. Uptake of screening is the poorest in younger women and increases with age to a peak at 50 to 54 years. In addition, uptake of screening was highest in women from the least deprived areas and fell with increasing deprivation, which is really worrying, as Alison Johnstone had mentioned. I thought that Elaine Seismith made a vital point about homeless or marginalised women not being screened. Again, that is something that needs to be addressed. So any abnormality will be picked up and dealt with, and only around 1 per cent of tests had high-grade abnormality. 7.2 per cent had low-grade and almost 92 per cent were clear. Screening uptake is highest in HPV vaccinated women across all ages when compared to non-vaccinated women. That may be due to immunised women being more aware of the risks involved after vaccinations thanks to the education during the immunisation programme. I believe that education is a key part in getting the message across. My hope is that it becomes the norm for women and girls, just like going for a dental check-up or eye examinations—no big deal, just something that we have to do. Let's get the message out loud and clear to women and girls. This test is too important to miss. It will give you peace of mind that everything is okay, but more importantly, it could save your life. The last of the open debate contributions is from Annie Wells. Thank you, Deputy Presiding Officer, and I, too, wish to thank Monica Lennon for bringing this debate to the chamber today during cervical cancer awareness prevention week. Cervical screening put simply saves lives. Despite that, however, one in four women are not taking up their invitation for a cervical screening, putting themselves at risk of having undetected cervical cancer. What is key is that we try to understand why screening attendance is falling, and what barriers are to women getting the test on, and how we ensure that every single woman has information and opportunities that they need to access cervical screening. Bearing in mind that this is a free health test available to every woman in Scotland, acknowledging the barriers and factors that prevent women from taking up their invitation is essential. As we have already heard, for many women, the test can be uncomfortable and slightly embarrassing. It is one of those tick box exercises that, if you put off among the list of countless other things to do, may have no immediate or obvious repercussions. A survey of more than 2,000 women by Jo's cervical cancer trust found that a third of young women were too embarrassed to go to their test because of body shape. For some women, it is much more difficult, possibly having had a previous bad experience at a test or an experience of sexual violence. That is why I was encouraged to hear from Emma Harper about the pilot for self-test, which I welcome. What is paramount is that women are given the information to allow them to overcome those barriers. If women feel embarrassed about having the test done, they need to be informed whether, through a public campaign or social media, that they can specify a female nurse that they need only undress waist down, and that, for most, the test is not painful at all. When reading around the topic, I was really encouraged to see celebrities posting about their own smear test experiences on social media. Ten years ago, Jade Gudev sadly lost her life to cervical cancer, after which cervical screening rates rose thanks to an extensive media coverage and her work in raising awareness. However, ten years later, statistics have dipped, as we have heard. In most alarmingly, in Scotland, the biggest fall in cervical screening uptake is among the 25 to 29-year-olds, with more than one in three not taking up their invitation. As cynical as sometimes might be about social media, the power to raise awareness among that group is great. There are many great campaigns out there that young women and men can join in to spread the word among their friendship groups. As we have heard, the smear for smear campaign, for example, encourages people to share their smeared lipstick selfies along with tips and words of support during cervical cancer prevention week. Innovation is, of course, key. In my hometown, Glasgow, I have had the pleasure of meeting representatives from Joe's Cervical Cancer Trust at the Beast's Civic Savvy Roadshow, once at the Cannons Street and once in George's Square as part of their mobile unit service. In those prime locations, it was easy to see how information could be easily shared. I, too, as Monica Lennon has already stated, was very pleased to see in the local press last week the initiative of the Glasgow reputation, who is offering a free wax treatment for anyone who has a confirmed smear test appointment. To conclude today, I would like again to thank Monica Lennon for bringing this debate to the chamber during cervical cancer prevention week. We cannot allow the cervical screening uptake to continue to slip any further, or we run the risk of seeing diagnosis rates for what is often a preventable cancer of rise. There is no one quick fix to turning around this situation, but, by working together and raising awareness, we can hopefully save lives. I now call Claire Hawke to respond to the debate for around seven minutes, please. Thank you, Presiding Officer. I would like to thank members who have contributed to this debate today and to Monica Lennon for bringing it to the chamber. Cervical screening is unique. Not only can it detect cancer early, but it can also prevent cervical cancer before it even begins. The screening test detects pre-cancerous cell changes, mainly caused by the human papilloma virus, a virus that 80 per cent of us will get at some point in our lifetime, and treatment as a result of screening prevents eight out of ten cervical cancers from developing. There is no doubt, therefore, that the cervical screening programme saves lives, and it is the best protection against cervical cancer. As a woman myself, who has been for a smear test, I believe that we must do all that we can do to encourage eligible women to take up their cervical screening invitation. I agree with members that it is disappointing that uptake rates for cervical screening continue to decline. Latest figures show that just 72.8 per cent of eligible women attend screening in Scotland, and that is down from 73.4 per cent in 2017 and around 80 per cent 10 years ago. The trend is not unique to Scotland, but it is mirrored across the UK. In my constituency of Rutherglen, the most recent uptake data ranges from a high of 84.7 per cent to a low of 62.4 per cent. Uptake of screening was highest in women from the least deprived areas and fell with increasing deprivation. What is putting women off getting tested? Evidence shows that there are a number of barriers, including complex emotional obstacles such as fear, body shame and embarrassment, to practical barriers such as struggling to attend an appointment due to work commitments or childcare. New research from Joe's cervical cancer trust and Scottish Government showed that two thirds of Scottish women are unaware that not attending cervical screening is the biggest risk factor for developing cervical cancer. Awareness raising is therefore very important, but we must also recognise that uptake is lowest in our least affluent communities. The Scottish Government's cancer strategy is investing up to £5 million in our NHS national cancer screening programmes, including Cervical to Improve Outcomes. Those funds are supporting innovative projects, working to tackle inequalities and encourage participation in screening programmes from communities where individuals are least likely to take part. So far, we have committed more than £2.7 million to support 25 projects. Cervical Cancer Prevention Week gives us the opportunity to recognise and celebrate the good work that is being undertaken to tackle inequalities of access and to raise awareness of cervical screening in Scotland. The Scottish Government warmly welcomes the input of Joe's cervical cancer trust to the Scottish Cervical Screening programme, and we work closely with the trust to encourage women to attend screening, especially in hard-to-reach groups. Joe's has received funding under the cancer strategy for a Glasgow outreach service, which targets specific groups where there are significant health inequalities and a higher rate of non-attendance. They work with local GP practices, sexual health clinics, community groups and volunteers to improve access to and uptake of cervical screening. Last year, Joe's ran their first-ever Scottish Bee Cervic's Savvy Roadshow, which visited high streets and retail parks across Scotland, increasing awareness by addressing public knowledge around cervical screening and cancer. I was pleased to learn that two community workers from my constituency of Rutherglen were trained as volunteers and joined the roadshow when it travelled to Lanarkshire. The Scottish Government cancer strategy is also supporting Clyde Gateway, Scotland's biggest and most ambitious regeneration programme to tackle inequalities in access to screening. The Clyde project includes the creation of additional monthly cervical screening clinics, and that gives women the choice of a more convenient appointment time, increasing flexibility and accessibility. Some of the projects mentioned earlier, I wonder if any of them involve working with women who are homeless. I was going to address that point a bit further on my speech, so I will do that if that is all right with Elaine Smith. They have also developed a community health pathway in the community of Burnhill in Rutherglen, the second-most deprived community in South Lanarkshire. 337 local residents have been consulted through door-to-door engagement, supplemented with residents on the street and via local activity groups. Those are just a few of the excellent projects that are currently under way and have only just touched the surface. It is vital that we continue to explore how screening can be more effective at reaching those in greatest need, and we will bring together all the learning gathered from those projects in a cohesive and co-ordinated strategy to reduce screening inequalities. We are complementing that work with our cervical screening awareness campaign flower, which started running in cinemas yesterday and will run across digital platforms from 28 January. The campaign targets 25 to 35-year-old women who we know are less likely to attend, and the campaign encourages women to take up their screening invitation and recommends women who miss their last appointment or who have never been screened to contact their GP. I would also like to take this moment to thank all those who are undertaking vital work in raising awareness of the importance of cervical screening. Finally, Presiding Officer, I would like to briefly mention our cervical cancer vaccination programme, which we introduced in 2008. Since the programme was introduced, uptake rates have remained high and continued to exceed 80 per cent. The programme has been evaluated since it began and is already showing encouraging and positive signs that the rate of cervical cancer caused by the HPV virus will reduce in future. However, the vaccine does not protect against all cervical cancers, so regular screening is still important. We will continue to be an essential part of our armory for years to come, and we must continue to get that message out to young women. If I could address a couple of the issues that members raised during the debate, Emma Harper spoke about self-screening. NHS Dumfries and Galloway is carrying out a small scale pilot in the board, and we are looking at the possibility of a national pilot. The UK screening committee is looking at the evidence for self-sampling, and we are awaiting their advice for proceeding further with that. I was asked by Miles Briggs and Alison Johnson about the potential of digital communications to encourage people to take up their invitation for screening. As part of the work under the cancer strategy, learning will be used to develop future communication plans, including looking at digital and technology. Elaine Smith asked me about homelessness, and there are a number of projects that are currently through the cancer strategy, where we are looking at how screening services can be improved for hard-to-reach groups, which would include women and men who are homeless, those who learn disabilities and those with mental health issues. We here tonight share the same ambitions to make cervical screening accessible to all women across Scotland, regardless of where they live and about understanding and reducing the barriers that women face. We all have a role in sharing the potential life-saving messages about cervical screening with all the women in our lives. Together, let's nip cervical cancer in the bud. That concludes the debate on cervical screening updates statistics, and I close this meeting.