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Medical science hasn’t served women as well as it could

In 40 years cancer survival rates have doubled but not everything is rosy — especially if you are fe

In 40 years cancer survival rates have doubled but not everything is rosy — especially if you are female.

On first hearing, it sounds like bad news. This year, around 717,000 men and 566,000 women in the European Union will die from cancer. However, adjusted for population changes, the death rates from cancer will be down 10 per cent in men and 7 per cent in women from 2007 levels.

These cheering figures were published in the Annals of Oncology last week. It's important to register the success of our fight against cancer. According to a survey carried out for Cancer Research UK in 2010, one-fifth of us fear getting cancer more than we fear debt, knife crime, Alzheimer's disease and losing a job. It may be that in 2012 the likelihood of getting into debt or losing a job has risen, but when it comes to cancer there is definitely reason to be, if not exactly cheerful, at least a bit less pessimistic.

In the past 40 years cancer survival rates have doubled. Nearly three-quarters of children with cancer are now cured; in the 1960s, three-quarters died. The reason? Basic research: improved diagnosis and treatments, and the development of nationwide screening programmes for breast, bowel and cervical cancers.

Not that everything is rosy – especially if you are female. That 3 per cent discrepancy between improved mortality for men and women is telling. Medical science hasn't served women as well as it could.

There is controversy over breast cancer screening, for instance. Though screening programmes are clearly useful for picking up cancers early, many clinicians are concerned about the rate of false positives. In October last year, a review found that 2,000 screeenings over a ten-year period would save one life, but ten women would have unnecessary treatment and 200 would undergo months of severe psychological trauma because of a misdiagnosis.

Cervical cancer screening is also under scrutiny. Research published this month in the British Journal of Cancer suggests the invasive and distressing cervical smear test might be better used only as a follow-up to a positive result for the less distressing human papillomavirus test.

Perhaps the most stubborn problem facing women and cancer is that the medical research establishment doesn't seem to like dealing with the female sex – even in its laboratory animals.

Most lab mice are male, even when researchers are using them to investigate diseases that are more likely to affect women. This is partly because male mice are cheaper but mostly because of a persistent but mistaken belief that female hormone variability will affect the results of experiments.

Bad news

Women are also under-represented in clinical trials; a 2009 study showed that less than 40 per cent of cancer trial subjects are women. Take into account that several cancers manifest and should be treated differently in women, and that the side effects of some cancer drugs are more severe for women, and it's clear that something is amiss.

A final piece of bad news for women: last week's report suggests that female lung cancers will rise by up to 7 per cent this year. The best way to fight this trend is to introduce measures that will deter young girls from taking up smoking, and one of the easiest options for this will come into view in the next few weeks. The government is about to launch a public consultation on tobacco packaging.

A wealth of studies shows that young people are far less interested in smoking when cigarette packaging is stripped of all branding. Since the vast majority of smokers today started as teenagers, introducing plain packaging would be good news for everyone.

Michael Brooks's "Free Radicals: the Secret Anarchy of Science" is published by Profile Books (£12.99)

Michael Brooks holds a PhD in quantum physics. He writes a weekly science column for the New Statesman, and his most recent book is At the Edge of Uncertainty: 11 Discoveries Taking Science by Surprise.

This article first appeared in the 12 March 2012 issue of the New Statesman, The weaker sex

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“A cursed project”: a short history of the Facebook “like” button

Mark Zuckerberg didn't like it, it used to be called the “awesome button”, and FriendFeed got there first. 

The "like" button is perhaps the simplest of the website's features, but it's also come to define it. Companies vie for your thumbs up. Articles online contain little blue portals which send your likes back to Facebook. The action of "liking" something is seen to have such power that in 2010, a class action lawsuit was filed against Facebook claiming teenagers should not be able to "like" ads without parental consent. 

And today, Facebook begins trials of six new emoji reaction buttons which join the like button at the bottom of posts, multiplying its potential meanings by seven: 

All this makes it a little surprising that Facebook CEO Mark Zuckerberg spent a good portion of the noughties giving the like button a thumbs down. According to Andrew Bosworth, Vice President of Advertising and Pages at Facebook (and known simply as "Boz") it took nearly two years to get the concept of an approval button for posts off the ground.

In a fascinating Quora thread, Boz explains that the idea of a star, plus sign or thumbs up for posts first came up in July 2007, three years after "TheFacebook" launched in 2004. Throughout these initial discussions, the proposed bursts of positivity was referred to as an "awesome button". A few months later someone floated the word "like" as a replacement, but, according to Boz, it received a "lukewarm" reception. 

The team who ran the site's News Feed feature were keen, as it would help rank posts based on popularity. The ad team, meanwhile, thought "likes" could improve clickthrough rates on advertisements. But in November 2007, the engineering team presented the new feature to Mark Zuckerberg, and, according to Boz, the final review "[didn't] go well". The CEO was concerned about overshadowing the Facebook "share" and comment features - perhaps people would just "awesome" something, rather than re-posting the content or writing a message. He also wanted more clarification on whether others would see your feedback or not. After this meeting, Boz writes, "Feature development as originally envisioned basically stops". 

The teams who wanted the button forged ahead with slightly different features. If you were an early user, you might remember that News Feed items and ads collected positive or negative feedback from you, but this wasn't then displayed to other users. This feature was "ineffective", Boz writes, and was eventually shut down. 

So when Jonathan Piles, Jaren Morgenstern and designer Soleio took on the like button again in December 2008, many were skeptical: this was a "cursed project", and would never make it past a sceptical Zuckerberg. Their secret weapon, however was data scientist Itamar Rosenn, who provided data to show that a like button wouldn't reduce the number of comments on a post. - that, in fact, it increased the number of comments, as likes would boost a popular post up through the News Feed. Zuckerberg's fears that a lower-impact feedback style would discourage higher value interactions like reposting or commenting were shown to be unfounded. 

A bigger problem was that FriendFeed, a social aggregator site which shut down in April 2015, launched a "like" feature in October 2007, a fact which yielded some uncomfortable media coverage when Facebook's "like" finally launched. Yet Boz claims that no one at Facebook clocked onto FriendFeed's new feature: "As far as I can tell from my email archives, nobody at FB noticed. =/". 

Finally, on 9 February 2009, "like" launched with a blogpost, "I like this", from project manager Leah Pearlman who was there for the first "awesome button" discussions back in 2007. Her description of the button's purpose is a little curious, because it frames the feature as a kind of review: 

This is similar to how you might rate a restaurant on a reviews site. If you go to the restaurant and have a great time, you may want to rate it 5 stars. But if you had a particularly delicious dish there and want to rave about it, you can write a review detailing what you liked about the restaurant. We think of the new "Like" feature to be the stars, and the comments to be the review.

Yet as we all know, there's no room for negative reviews on Facebook - there is no dislike button, and there likely never will be. Even in the preliminary announcements about the new emoji reactions feature, Zuckerberg has repeatedly made clear that "dislike" is not a Facebook-worthy emotion: "We didn’t want to just build a Dislike button because we don’t want to turn Facebook into a forum where people are voting up or down on people’s posts. That doesn’t seem like the kind of community we want to create."

Thanks to the new buttons, you can be angry, excited, or in love with other people's content, but the one thing you can't do is disapprove of its existence. Championing positivity is all well and good, but Zuckerberg's love of the "like" has more to do with his users' psychology than it does a desire to make the world a happier place. Negative feedback drives users away, and thumbs-down discourages posting. A "dislike" button could slow the never-ending stream of News Feed content down to a trickle - and that, after all, is Facebook's worst nightmare. 

Barbara Speed is a technology and digital culture writer at the New Statesman and a staff writer at CityMetric.