Style guide for health and patient information pages

Cancer Research UK’s health and patient information aims to provide understandable, accurate, comprehensive and up to date information about cancer, treatments and support services in the UK.

Our information aims to:

help people reduce their risk of cancer and adopt a healthy lifestyle
help people understand their situation
help people to know how cancer and treatments may affect them
explain the choices available to them
enable them to make decisions where necessary

Our readers should feel informed, supported and empowered.

Our readers

For health information, the primary audience is the general public.

For patient information, the primary audience is people affected by cancer and their relatives and friends. This includes people waiting to be diagnosed, having cancer tests, and people undergoing treatment and coping with side effects. It also includes survivorship and end of life issues.

Although the information covers sometimes very complex, medical situations it must be clear, concise and understandable to people with low literacy levels.

Sensitivity

Many of the people reading our information are in difficult or frightening situations. For example, they might be:

worried that they have cancer
trying to cope with treatment side effects
worried about their prognosis

Our information sensitively acknowledges the feelings and emotions that cancer and its treatment can cause.

Meeting user and business needs

Where relevant we demonstrate our involvement in research and raise awareness of our role in improving diagnosis, treatment and survival for people with cancer.

When planning our writing we ask ourselves:

what do we want the reader to know (facts)?
how do we want them to feel (for example, informed, reassured)?
which action do we want them to take (such as read the whole page, go on to read another page, or go to their doctor)?

Patient stories

We include patient stories to give a human interest. These are usually quite popular pages.

Inclusive language

Generally, we use person-centred language and aim to be as inclusive and sensitive as possible. In trying to use the most inclusive and sensitive terms, we recognise that not everyone will agree with our chosen language. We acknowledge that some people may choose to describe themselves differently.

Age

Avoid describing age groups that suggest they are less able. Be sensitive to different age groups, using terms that they would use themselves.


Use	Instead of
older people	the elderly
	old people

Medical condition

Describe a person first of all as an individual, followed by their condition. Only include if it is necessary for the information.


Use	Instead of
person with cancer	cancer patient
person with diabetes	diabetic person
person with a mental health condition or problem	mentally ill

Disability

We use 'disabled person' instead of 'person with a disability'. This follows the Social Model of Disability, as outlined by disability charities, such as Scope.


Use	Instead of
disabled person	person with a disability

Nationality, race, ethnicity and religion

Only refer to nationality, race, ethnicity and religion when it is relevant to the information. For example, ‘Prostate cancer is more common in Black men than White men. It is least common in Asian men’.

Skin tone

At times, we need to refer to different skin tones. For example, some skin symptoms (such as a rash) may appear differently on different skin tones, or the risk of skin cancer can vary depending on skin tone.

In the past, skin symptoms were often described as what they looked like on white skin. We are in the process of updating our content to make sure we reflect different skin tones wherever possible. This includes visual content. Sometimes it can be hard to be specific about symptoms on all skin tones as there are currently limited resources to base this information on.

We follow the NHS content style guide about skin tone. So we refer to brown, black, and white skin tones. When discussing several skin symptoms, we generally include those that affect everyone in the same way first and then those that may appear differently depending on skin tone.

Sex, gender and sexual orientation

Use gender neutral language wherever possible.


Use	Instead of
people	men, women
they, them, name of person if known	he, she
their	his, her
parents, carer, guardian	mother, father, mum, dad
partner, carer	boyfriend, girlfriend, husband, wife
child, children	son, daughter

Avoid gender specific language when describing a profession or job

For example, ‘Ask if there is a specialist nurse and if you can speak to them [not her]’. Or ‘Contact your doctor and tell them [not him] what is wrong’.

There may be exceptions to this. For example, ‘You can ask to see a female doctor if you want to’.

Sexual orientation

Sexual orientation describes who a person is attracted to and has feelings for romantically, physically and emotionally.

Use ‘sexual orientation’, not ‘sexual preference’.
Avoid language that assumes all or most people are heterosexual.

Clarity

To maintain clarity, our information will at times refer to male, female, men and women. This is to help people of all literacy levels understand our information. For example, this might be when describing parts of the body, who the cancer affects and the results of studies and trials.

We acknowledge that this information also applies to some people who are trans or non-binary.

Key terms used in inclusive language policy

Heterosexual

Refers to a man who has a romantic and/or sexual orientation towards women or to a woman who has a romantic and/or sexual orientation towards men.

Trans

An umbrella term to describe people whose gender is not the same as, or does not sit comfortably with, the sex they were assigned at birth.

Transgender man

A term used to describe someone who is assigned female at birth but identifies and lives as a man.

Transgender woman

A term used to describe someone who is assigned male at birth but identifies and lives as a woman.

Non-binary

An umbrella term for people whose gender identity doesn’t sit comfortably with ‘man’ or ‘woman’.

The meaning of these terms is courtesy of the Stonewall website, accessed December 2023.

Plain English

All our information complies with plain English guidance produced by the Plain English Campaign:

We use various tools to help us achieve this. For example, we aim for grade 5 or lower in Hemingway Editor (though this is not always possible if explaining medical terms). Hemingway grade 5 is the same as school year 6 in the UK. Year 6 is for 10 to 11 year olds. Ideally we aim for a reading age of 9 to 11 year olds.

Style points

When writing we follow these guiding principles:

Write in plain English
Be clear and concise.
Use the active voice rather than passive – ‘Your nurse will give you the injection’ rather than ‘You will be given the injection by your nurse’.
Keep the information short and simple and avoid unnecessary words.
Have an average sentence length of 15 to 20 words (from the Plain English Campaign).
Create accessible and inclusive content.
Use words that are appropriate and understandable for the reader.
Avoid jargon: use simple descriptions such as ‘an endoscope is a flexible tube that shows the lining of your food pipe’.
If including technical terms use the plain English term first, followed by the technical term in brackets – for example, 'difficulty swallowing (dysphagia)'.
Use contractions (such as you’re or can’t) but don’t overuse and avoid with sensitive information such as ‘No one can tell you how long you’ll live’. Using a contraction in this sentence can make it sound flippant.
Try to avoid adverbs, but include them where they are helpful. For example, ‘your nurse gently puts the tube into your bladder’.
Include clear calls to action (the pink link) where appropriate – ‘Find out about possible treatments for your cancer'.
Don’t use italics, underlining, exclamation marks or capital letters in words such as Doctor or Radiographer.
Generally avoid using bold text unless it is important to emphasise something (for example, side effects that need to be reported urgently to a doctor).
Avoid saying patient – use the term ‘people with cancer’.
Don’t use Oxford commas unless the sentence becomes difficult to understand without them: an Oxford comma is a comma used after the penultimate item in a list of three or more items, before ‘and’ or ‘or’. For example: [...] a meal, salad, and a drink.
Use UK English and don’t use Americanisms, including American spellings. Verbs should end in -ise, not -ize. For example, recognise.
Don’t use the Registered trademark ® or the Trademark symbol ™. This affects the user’s flow of reading.
Avoid sentence fragments – visit the Grammarly website for an explanation of a sentence fragment
Avoid comma splices - visit the every word counts website for an explanation of a comma splice

Tone of voice

Our writing style is authoritative and concise but caring and supportive. It demonstrates that we understand and empathise with the difficulties faced by people affected by cancer. And it gives them confidence that we can help by providing accurate, evidence based and comprehensive information.

Our tone of voice is human. We write as though we are speaking directly to the reader:

Be direct and personal – we use ‘you’ and ‘your’ when appropriate. Be aware of when not to use it. For example, ‘Cancer can occur anywhere in your food pipe (oesophagus).’ This should say ‘the food pipe (oesophagus)’.
Be sensitive without obscuring the facts.
Use an authoritative but friendly style.
Write in the present tense – for example, ‘You lie down on a treatment couch and your nurse puts a drip into your arm’.
We use the same voice across all content but vary our tone for different content types – for example, drug information is very factual but we write more sensitively about coping with side effects, advanced cancer or survival.

Words to avoid (and alternatives)

We use simple words and phrases. Use the simple terms below instead of more complex ones.

Affected (as in affected lymph nodes) – cancer in one or more lymph nodes
Aggressive – faster growing
Anti coagulant clinic – blood clinic
Arise from – start from, or develop from
Attend – go to
Cosmetic result – appearance after
Chemotherapy regimen – chemotherapy drug combination or combination of chemotherapy drugs
Decrease / reduce – lower
Defined as – means
Discuss with – talk to
Distinguish – tell the difference between
Experience (as in side effects you may experience) – have
How effective it is – how well it works
In combination with – with
Inform – tell
Initial – first
In other words – so
Insert – put in
In spite of the fact that – although
Lymph nodes affected by cancer – lymph nodes containing cancer cells
More effective – works better than
Most appropriate – best
Occur – happen
Positive lymph nodes – lymph nodes containing cancer cells
Prior to – before
Progress (as in cancer progression) – grows
Receive treatment – have treatment
Return – come back
Requires – needs
Sufficient – enough
Suspicious (as in cells) – abnormal
Tablet form – tablets
The patient – ‘People with cancer’ or ‘you'
Thereafter – after that
Vast majority of – most
What is the incidence of – How common is

You can see more alternative words and phrases on the Plain English Campaign website.

Detailed style guide - A to Z

The information below includes guidance on specific details of style related to our cancer information. We may also refer to Cancer Research UK's main style guide for the website if we don't cover it here. We can discuss any style issues at our regular editing meetings. Any decisions are then added to this guide if appropriate.

A

'A' or 'an'. We don't use 'an' before words beginning with 'h', unless the 'h' is silent. For example, 'a herb' not 'an herb'; 'a hospital', not 'an hospital'.

Abbreviations. We don't generally use abbreviations unless it is detrimental not to, preferring to write in full. If we do use abbreviations, we don't use full stops between letters.

Accident and Emergency (A&E) rather than 'Casualty'. Most hospitals now refer to Accident and Emergency (A&E) or Emergency departments rather than Casualty.

Acronyms. Don't put full stops between letters, so NICE not N.I.C.E. Spell out in full on first use, with abbreviation in brackets following. After that, use the abbreviation for the rest of the page. We don't use an apostrophe after a plural abbreviation, for example GPs not GP's.

Adviser not advisor (such as financial adviser).

Alveoli are tiny air sacs (not sacks).

And/or - we avoid using and/or as it can be confusing for our readers and causes ambiguity. Depending on the context you may be able to replace it with 'or' alone. Or you can write 'or both'. For example [...] vomiting or a headache or both.

Anti convulsant is written as two words without a hyphen.

Anti metabolite is written as two words.

B

Bloodstream is all one word.

Brainstem is one word.

Breastfeeding is all one word.

Breastbone is one word.

Bullet points - see Lists in Researching and writing

C

Cancer Research UK should be written as seen here and never abbreviated, except in internal communications.

Capitals. Don’t overuse. Doctor and nurse do not have a capital letter. Professor has a capital if followed by a specific name, such as Professor Nick James.

CAR T-cell therapy has the hyphen between the T and cell

Casualty department – do not use this term: use 'Accident and Emergency (A&E)' instead.

Chemoradiotherapy – we use this term rather than chemoradiation.

D

Dietician / Dietitian – we use 'dietitian' as this is how the Association of UK Dietitians spell it.

Dropdown – all one word (as in dropdown menu).

Drug names. Brand names always start with a capital letter but generic names don't, for example Panadol and paracetamol. For drugs yet to be named (ABC-1234), use a hyphen as easier to read while making sure the two 'parts' of the name are connected. For drug combinations use the most commonly used term in hospitals. Add other options in brackets in the title or content. We don’t use the registered trademark symbol when mentioning brand names as it interferes with the flow of reading.

E

Examples. We tend not to use 'eg'. The term 'eg', although common, makes reading difficult for some people. Instead we use 'such as' or 'for example', whichever works best in the specific context.

For a comparison, use 'such as' not 'like'. Like means 'similar to'. It does not mean ‘the ‘same as', or 'for example'. So, 'you might have a different chemotherapy drug, such as epirubicin'.

External link - when linking to an external site, use the words ‘Visit the xxx website’. This indicates to the reader that they will be leaving the Cancer Research UK website.

F

Factsheet is all one word.

Fewer – see Quantity.

Follow up. Refers to appointments after treatment has finished. Can also be called check ups.

Food pipe is our accepted colloquialism for oesophagus. Some people are not familiar with 'gullet'. Also include oesophagus in brackets afterwards for clarity.

G

Gallbladder is one word.

Gene names – always use standard gene names and symbols, which can be found at www.genenames.org. When first used, give the full gene name followed by its symbol in brackets – for example, insulin-like growth factor 1 (IGF1). Generally, gene symbols don’t contain punctuation such as hyphens.

Conventionally, symbols for genes are italicised (for example IGF1) whereas symbols for proteins are not (for example IGF1). We don’t use italics and so need to make clear in our writing whether we are talking about a gene or a protein.

Government has a capital G if we are talking about 'the Government' (as in UK).

GP surgery rather than GP practice. This is based on work done by our Digital Analyst.

Graft versus host disease is written either in full (without hyphens) or as an abbreviation GvHD (small v). Use the term in full with the abbreviation in brackets in the first instance - graft versus host disease (GvHD) - and then GvHD for the rest of the page.

H

Healthcare team - healthcare is one word.

Heartbeat - the noun - is one word.

Home care - is two separate words.

Human papillomavirus (HPV) - use human papillomavirus instead of human papilloma virus. Add phonetic spelling (hyoo-muhn pa-puh-low-muh-vai-ruhs). The first time it's mentioned on a page, include HPV in brackets and then refer to just HPV for the rest of the page.

Hyphens. The accepted site practice is not to use hyphens. They clutter the text and make it more difficult for less able readers. Although we don’t use hyphens, we don't combine the prefix with the rest of the word as this can be even more difficult to read. For example, anti angiogenic, not antiangiogenic; anti inflammatory, not antiinflammatory.

Exceptions to this policy are some medical terms or acronyms that usually include a hyphen, or some terms where removing the hyphen could change or confuse the meaning.

Medical terms include some cancer types (such as non-Hodgkin lymphoma), drug regimens (for example, R-CHOP), and some drugs or drug targets that are acronyms (such as G-CSF and PARP-1). Examples of terms where removing the hyphen could change the meaning or make the sentence harder to read include:

flu-like
skin-like
life-like

I

Inpatient is one word.

Intra peritoneal (IP) is two words.

L

Less – see Quantity

Licensed – licence is a noun which means 'a permit to do something' (a driving licence), whereas license is a verb meaning 'give a permit to someone: allow something' (this drug is licensed for the treatment of cancer). In American English, both the noun and the verb are spelled license.

Link (external) - when linking to an external site use the words ‘Visit the xxx website’. This indicates to the reader that they will be leaving the Cancer Research UK website.

Life threatening without a hyphen.

Long term without a hyphen.

Lightheaded is written as one word.

M

May or might – use ‘can’ if the option is usually available to most people. For example, 'You can take painkillers'. Use ‘may’ if it is more uncertain (for example 'You may be able to have chemotherapy, depending on….').

Generally ‘may’ suggests a greater possibility of something happening than ‘might’.

Medicine rather than medication - we usually use medicine as generally easier to understand than medication.

Mouth care is two words.

MRI is an MRI scan but a magnetic resonance imaging scan.

Mucous or mucus. Mucus is a noun and mucous is an adjective. Therefore, the stuff that clogs up your nose when you have a cold is mucus. But the membranes that produce mucus are 'mucous membranes'.

Multi kinase inhibitor or Multi TKI is written without a hyphen.

N

Neo adjuvant should be written as two separate words as it makes it easier to read.

Non-Hodgkin lymphoma is hyphenated. We write this as non-Hodgkin lymphoma if it's in the middle of a sentence.

Numbers. We generally write all numbers in figures. Use your discretion for 'one' and 'two' as these in figures can sometimes look odd depending on the sentence.

When writing about proportions use natural frequency (10 out of 100 people) as well as percentages (10%). Many people find this easier to understand. For example, 'More than 10 in 100 people (more than 10%) will have these side effects'.

Don’t have too many numbers in one sentence as this makes information hard to understand.

Avoid starting a sentence with a number.

Percentages are always in figures - 2%.

Always use commas for numbers over 999 - such as 1,000.

We do not include a space between a number and its unit of measurement, such as centimetres or Celsius (C) - for example 5cm or 38C.

O

OK rather than okay. But we try to avoid using this where possible. It will depend on the context of the page.

Online is one word.

Opening times format: Monday to Friday, 9am to 5pm.

Organisations are singular, not plural. So NICE has...not NICE have.

Outpatient is one word.

P

Painkillers should be one word.

Pee. We use 'pee' in preference to urine or wee. We know that generally 'pee' is easier to understand, particularly for people who find reading difficult. We may refer to urine when explaining medical terminology or tests.

Poo. We use 'poo' in preference to stool. We know that generally 'poo' is easier to understand, particularly for people who find reading difficult. We may refer to stools or faeces when explaining medical terminology or tests.

Percentages. Many people don't understand these. Always express risk as 'x people out of every 100' and then put percentage afterwards in brackets. So, '80 out of every 100 people (80%)'.

PET-CT has a hyphen (to avoid confusion with PET and CT).

Pre cancer is two words as it is easier to read.

Post menopausal is two words.

Pre menopausal is two words.

Peri menopausal is two words.

Pre paid is two words.

Pre surgery is two words.

Philadelphia chromosome should have a capital p and lower case c.

Pronunciation guide. As an aid to our site users, we give phonetic guidance on how to say difficult words, particularly medical ones that may be unfamiliar. For example, lymphocytic (pronounced lim-fo-sit-ik). Try not to use real words as part of the phonetic spelling as it can confuse. For example, 'in-juicy-bull' for inducible. We don't use capital letters to show emphasis. For example blin-uh-too-mo-mab, not blin-uh-TOO-mo-mab.

Protein names - always use standard protein names and symbols. When first used, give the full gene name followed by its symbol in brackets - Insulin-like growth factor 1 (IGF1). For protein symbols, all letters are in upper case, such as IGF1. The Greek alphabet is never used, so TNFA not TNFα. Generally, protein symbols do not contain punctuation such as hyphens.

Q

Quantity. There are grammatical rules about the use of 'less' and 'fewer'. If it is possible to count what you are describing, use 'fewer'. If not, use 'less'. For example, there are fewer people on the beach, but less sand.

Quotation marks. Always use single quote marks (') and not double quote marks ("). As a general rule though we try to avoid using quotation marks as they clutter the page.

R

Radio waves is two words (not radiowaves).

Risk communication. All risk information should be presented as natural frequency, so '1 in X'. We also generally put the percentage in brackets in an appropriate place in the same sentence. Try to keep figures out of 100 for consistency and avoid confusion, particularly if there are several figures on the same page. For example; 'About 20 out of 100 people (about 20%) are diagnosed with stage 4 XX cancer' rather than 'About 1 in 5 people (about 20%) are diagnosed with stage 4 XX cancer'.

Registered trademark - we don’t use the registered trademark symbol when mentioning drug names as it interferes with the flow of reading.

S

Sacs (not sacks) when describing certain body parts. For example, alveoli are tiny air sacs, or a pericardial sac or scrotal sac.

Short sentences – Have an average sentence length of 15 to 20 words. We can use conjunctions to start sentences, such as And and But. But this should only be done if there is a genuine need for the 'and' or the 'but'. For example, the second sentence is dependent on, or an extension of the first. Don't just put them in for the sake of it.

Short term doesn't have a hyphen.

Straight away is two words.

Stevens Johnson syndrome doesn't have a hyphen.

T

Therapeutic radiographer – we use this term to describe a health professional who is trained to give radiotherapy. Use this term in full in the first instance. For easier reading, we can then refer to 'your radiographer' for the rest of the page.

Trans is a common medical prefix. We write this as two words without hyphens, for example trans rectal or trans dermal.

Transgender is written as one word. Trans people, trans man and trans woman are two separate words.

Trademark symbol - we don’t use the registered trademark symbol when mentioning drug names because it interferes with the flow of reading.