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Are 3D mammograms better than standard imaging? A diverse study aims to find out_我的网站

一 |     8月25日消息，近日，爱尔兰卡洛小镇发生一起惨烈车祸：五名十几岁的未成年少年驾驶偷来的宝马车深夜飙车逆行，在躲避警方追捕时与一辆民用轿车迎头相撞，当场全部身亡，而被撞车辆内的三姐妹与一名7岁儿童重伤送医，至今未脱离生命危险。    据悉，死者均为爱尔兰知名青少年犯罪团体“幸运抽奖帮”的核心成员，这个由60至100名未成年人组成的团伙，早已在当地臭名昭著。    Are 3D mammograms better than standard 2D imaging for catching advanced cancers?A clinical trial is recruiting thousands of volunteers — including a large number of Black women who face disparities in breast cancer death rates — to try to find out.People like Carole Stovall, a psychologist in Washington, D.C., have signed up for the study to help answer the question.“We all need a mammogram anyway, so why not do it with a study that allows the scientists to understand more and move closer to finding better treatments and ways of maybe even preventing it?” Stovall said.The underrepresentation of women and minorities in research is a long-simmering issue affecting health problems including Alzheimer’s disease, stroke and COVID-19. Trials without diversity lead to gaps in understanding of how new treatments work for all people. “Until we get more Black women into clinical trials, we can’t change the science. And we need better science for Black bodies,” said Ricki Fairley, a breast cancer survivor and advocate who is working on the issue.Black women are 40% more likely to die from breast cancer than white women and tend to be diagnosed younger. But it’s not clear whether 3D mammography is better for them, said Dr. Worta McCaskill-Stevens of the National Cancer Institute.“Are there populations for whom this might be important to have early diagnosis?" asked McCaskill-Stevens. "Or is it harmful,” causing too many false alarms or unneeded follow-up tests and treatments?McCaskill-Stevens, who is Black, leads NCI’s efforts to boost access to cancer research in minority and rural communities. She has joined the study herself.The newer 3D technique has been around for a decade, but there’s never been conclusive evidence that it's better than 2D at detecting advanced cancers. The screening technique combines multiple pictures of the breast taken from different angles to create a 3D-like image. Both 3D and 2D mammograms compress the breast and use low doses of radiation.Prior studies suggest that 3D finds more cancers than 2D, but catching more cancers doesn’t necessarily mean more lives saved. Some cancers missed by standard screening may not progress or need treatment. Previous studies did not randomly assign patients to a screening method, the gold standard for research.The notion “that if it’s new, it’s shiny, then it’s better,” isn’t necessarily true, McCaskill-Stevens said. “Until we have the evidence to support that, then we need well-designed randomized trials.”The trial has enrolled nearly 93,000 women so far with a goal of 128,000. The NCI-funded study is now running in Canada, South Korea, Peru, Argentina, Italy and 32 U.S. states. A site in Thailand will soon begin enrolling patients.“We added more international sites to enhance the trial’s diversity, particularly for Hispanic and Asian women,” said Dr. Etta Pisano, who leads the study. Overall, 42% of participants are Hispanic. As recruiting continues, enrolling Black women and other women of color will “absolutely” continue as a priority, Pisano said.Participants are randomly assigned to either 2D or 3D mammograms and are followed for several years. The number of advanced cancers detected by the two methods will be compared.At the U.S. study sites, 21% of study participants are Black women — that's higher than a typical cancer treatment study, in which 9% of participants are Black, McCaskill-Stevens said.The University of North Carolina has signed up more Black women than any other study site. Nearly a quarter of the nearly 3,000 women enrolled at UNC’s two locations are Black.“Women in North Carolina want to take part in something that’s bigger than them,” said Dr. Cherie Kuzmiak, who leads the UNC arm of the study. “They want this active role in helping determine the future of health care for women.”In Washington, D.C., word of mouth has led to successful recruiting. A chance encounter at her hair salon persuaded Stovall to join the research. While waiting for a hair appointment, she met Georgetown University cancer researcher Lucile Adams-Campbell. The two, both Black, started chatting.“She explained how important it was to get women of color into the program,” said Stovall, who jumped at the chance to catch up on her mammograms after the COVID-19 pandemic delayed screening for her and thousands of others.For Stovall, there was a personal reason to join the research. Her sister recently completed treatment for triple negative breast cancer, an aggressive type that affects Black women at higher rates than white women. Women ages 45 to 74 without a personal history of breast cancer are eligible for the study, which launched in 2017. Many women also are providing blood and cheek swab samples for a database that will be mined for insights.“It’s a dream that people had since the beginning of screening that we wouldn’t fit everybody into the same box,” Pisano said. The study's findings could “reduce disparities if we’re successful, assuming people have access to care.”Stovall, 72, had a brief scare when her mammogram, the traditional 2D type, showed something suspicious. A biopsy ruled out cancer.“I was extremely relieved,” Stovall said. “Everybody I know has heard from me about the need for them to go get a mammogram.”___The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.。    他们不以牟利为目的，专以偷车、高速逆行、占道狂飙等危险驾驶行为博眼球，将作案过程拍成视频发布到社交媒体，靠惊险刺激的画面收割流量与崇拜。     行为包括从高速公路深夜掉头逆行横跨多车道，到拥堵时段占用应急车道极速飞驰，每段视频在被删除前都能收获数百万播放量，他们越放肆、越危险，获得的点赞与关注就越多。    在该团伙的带动下，爱尔兰汽车盗窃案件数量自2021年起近乎翻倍，从每年3951起飙升至7893起，仅去年一年，该团伙就涉嫌犯下至少300起入室盗窃与偷车案件，多名路人因他们的危险驾驶受伤致残。         值得一提的是，2021年爱尔兰警方曾因追缉逆行车辆造成伤亡被起诉，此后定下规矩，绝不追逐高速公路上的逆行车辆，这反而为飙车少年提供了新思路——只要驶入逆行车道，警方就只能放弃追捕。    而爱尔兰《儿童法》规定仅在万不得已时才可拘留未成年人，即便11名核心成员累计被控427项罪名，也无一人被实际关押。    事故发生后，当地民众普遍表示并不同情涉案少年，爱尔兰总理将问题归咎于社交媒体平台，声称要对TikTok处以15亿欧元罚款，但舆论普遍认为这只是口头威胁，并不会落到实处。     更令人担忧的是，惨剧并未止住模仿者，事发几天后，又有少年驾车在公路逆行酿成车祸。              

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