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

一 |     中新社北京8月26日电 (记者 黄钰钦)8月25日，由中共中央对外联络部和美国亚洲协会共同主办的第三届中美1.5轨对话在北京举行。来自中方有关部门、地方政府、智库、高校以及美国亚洲协会等方面的约40名代表，围绕“建设性战略稳定——新时代中美务实合作”进行交流。    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.。                        　　所谓一轨，通常指国家政府之间的正式外交沟通，由现任政府官员代表国家进行谈判和磋商，有明确的官方属性。二轨则更多是非官方交流，参与者多是智库学者、前政要、企业人士等，不代表政府进行正式谈判，但能够在相对宽松的环境中交换观点，为政策制定提供参考。         　　两者之间的1.5轨，是介于官方正式外交和民间对话之间的沟通，参与者既包括政府部门等方面人士，也包括智库、学界、工商界等人士。

二 |          　　“1.5轨最大的特点，是在官方和民间之间搭起一座特殊桥梁。”中国人民大学全球治理与发展研究院高级研究员苏浩指出，它既能够接触政策层面的现实问题，又能保留较灵活的讨论空间。         　　这种机制并非中美间独有。早在2015年，中韩双方就举行了第一次1.5轨对话，旨在加强两国政府和二轨对话间的对接。         　　中美1.5轨对话，同样与中美关系需要保持沟通的大背景密切相关。2023年，首届中美1.5轨对话以视频方式举行。2024年，第二届对话在北京举行，讨论议题进一步延伸至经贸、气候变化、卫生、人工智能、人文交流等领域。         　　从三届对话来看，这一机制的功能不断拓展。

三 | 本届对话共设置增进中美政治互信，拓展中美经贸合作，探索中美人工智能与科技、国际地区事务合作，促进中美医疗合作与人文交流等四个议题。         　　“这说明1.5轨对话正在从‘保持沟通’走向‘寻找合作’。”苏浩说，三届对话最重要的成果，未必是形成多少具体文件，而是逐步形成可以持续运转的沟通平台，让双方不同领域人士保持接触，把现实问题和合作设想带到桌面上讨论。         　　中美关系正处于重要节点。今年5月中美元首历史性会晤确立了中美建设性战略稳定关系的新定位，为未来3年乃至更长时间的中美关系作出战略指引。         　　“中美关系越是复杂，越需要保持多层次、多领域沟通。

四 | ”苏浩认为，“1.5轨能够做的，就是把分歧讲清楚，把可以合作的事情找出来，通过持续交流减少误判。”          　　一个稳定的中美关系需要元首外交引领，也需要政府部门间的专业沟通，还需要智库、企业、学界等社会各界保持接触。三届中美1.5轨对话的举行，正是这种多层次的体现，为中美管控分歧、增进理解、寻找合作创造更多可能。(完) 【编辑:曹子健】。

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