I first came across this very instructive episode in the history (1986-2005) of modern medicine through the work of Gilbert Welch. (His research is featured in this article at WebMD.) The concept of "overdiagnosis" has stuck with me ever since, and has applications, I think, also into the diagnosis of social ills. Indeed, perhaps those who have been reading along these last few days already know where I'm going with this. I think of Tim Hunt as a victim of the overdiagnosis of sexism in science today. In fact, the 2014 interview that has been cited to support a deeper charge of "ingrained" sexism (of which his "joke", then, was just an expression) seems to make the same point.
Before I make the connection, let me just point out a few more features of the PSA overdiagnosis problem. Treating a million men for a cancer that would never have caused them any health problems is, not just inconvenient to them, but very expensive for society. The treatment itself is costly and they work less efficiently while they are undergoing it. Also, we have to ask whether the effect of treating them does anything to bring down the overall level of mortality from cancers. Welch found that, using a conservative estimate, you have to treat around twenty people unnecessarily in order to save one additional person from death by prostate cancer. The reason for this is that mentioned before, namely, that not all cancers develop into what we can properly call a "disease", i.e., a health issue. He quotes (in this video) from George Crile's "Plea Against Blind Fear of Cancer" , who explains that "to say that a patient has a cancer gives as little information about the course of the disease as to say that he has an infection". That is, it may lead to his death if untreated, it may be treated and cured, or it may go away without any treatment whatsoever. Time, sometimes, is a healer.
Cancer is becoming increasingly less dangerous to men, prostate cancer included. This is the result of increased knowledge, of course, including better means of detection and, importantly, better means of treatment. But PSA screening, at least until its ill effects were discovered, proved to be a well-intentioned but ultimately harmful approach. It caused more harm than it prevented.
Consider also, the false positives. These are people whose PSA screenings come back positive, but who are later found not to have cancer. Their lives are turned upside down between the first and the second test. "These men have already taken a hit," as Welch puts it, "They've been told they have a diagnosis of prostate cancer. By the time you are told you have prostate cancer, you are all nervous, you have already lost some sense of well-being. The real issue is, do you want to play this game?" That is, the question is whether you want to get screened. Welch, and the American Cancer Society, no longer recommend it.
In my opinion, Tim Hunt was a false positive "sexist", caught in a regime of overdiagnosis of a very real, but smaller, problem, namely, gender inequality in science. When I say "false positive" I mean that Tim Hunt, in that fateful toast, failed a very sensitive test for sexism, namely, the habit of calling women "girls", that upon further testing would have revealed no actual, practical sexism underneath. He doesn't actually treat women different from men qua scientists and is mindful of their particular problems qua women, such as the possible need for a creche near a lab. Even if you don't quite buy that, then you might grant that his sexism was like a microcancer that would never grow into a full-blown malignancy, a microsexism (to use a suggestive term these days) that would never become the full-blown misogyny he was immediately accused of. Indeed, in all likelihood, Tim Hunt's views about women, like most men his age, had probably mellowed over the last thirty years, owing to increasing contact with intelligent (if sometimes "distractingly sexy") women in the lab. He was harmless and only getting better.
Welch points out that when we introduce new methods of early diagnosis we always discover that a lot more people had the disease than we thought. It's because we're looking much more closely. In what at first seems a paradox, however, a lot fewer people are at the same time dying of them. We certainly have that in the case of women in science. While it would seem that sexism is rampant and on the rise and proliferating in new forms, the amount women in science is increasing, and they are making increasingly successful careers there too. I don't know, but maybe this was also what was on Sir Tim's mind when he answered that interview question for Lab Times in 2014, for which he was accused of claiming that sexism isn't a problem in science. He was simply saying that it's a problem that is naturally going away, and that we may cause more harm than good by trying to "treat" the remaining microsexists that are, on the whole, unlikely to cause any trouble. If we look closely enough, there is a little sexism in everyone, but not only are there better ways to spend our time and resources, there is no need to treat a condition that will not otherwise cause anyone any harm.
To steal some sentences from Gilbert Welch, these men really take a hit. They've been outed as unreconstructed sexists. By the time everyone thinks you're a sexist monster, you are nervous and you have already lost some sense of well-being. That's when the BBC comes looking for you. The real issue is, do you want to play this game? Do we?