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Style guide for health and patient information pages

Read the style guide for Cancer Research UK's pages on health information and patient information.

About our information

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 life style
  • help people understand their situation
  • 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.

Clarity

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 coming to our web pages or reading our printed information are in difficult or frightening situations: for example, they might be worried that they have cancer, or may be having treatments and coping with severe side effects. They may be worried about their prognosis. Our information sensitively acknowledges the feelings and emotions that cancer and its treatment cause.

Meeting user and business needs

Throughout our information 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 consider:

  • what do we want the reader to know (facts)
  • how do we want them to feel (eg 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.

Plain English

All our information complies with plain English guidance:

  • How to write in plain English: http://www.plainenglish.co.uk/files/howto.pdf
  • How to write medical information in plain English: http://www.plainenglish.co.uk/files/howto.pdf
  • The A to Z of alternative words: http://www.plainenglish.co.uk/files/alternative.pdf

Style points

When writing we follow these guiding principles:

  • Write in plain English – grade 5 or lower in Hemingway app.
  • Be clear and concise.
  • Use the active voice rather than passive – eg ‘Your nurse will give you the injection’ rather than ‘You will be given the injection by the nurse’.
  • Keep the information short and simple and avoid unnecessary words.
  • Have an average sentence length of 16 words or under (from the Fleisch readability guidance).
  • 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 – eg. difficulty swallowing (dysphagia).
  • Use contractions (eg. 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.
  • Avoid adverbs, but include them where they are helpful, eg. ‘The nurse gently puts the tube into your bladder’.
  • Include clear calls to action (the pink link) where appropriate – for example, ‘See your doctor if you have any of these symptoms.
  • Don’t use italics, capitals (in words such as Doctor or Radiographer), underlining or exclamation marks.
  • Generally avoid using bold text unless it is important to emphasise something (eg. 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’ (eg. a meal, salad, and a drink).
  • Use UK English and don’t use Americanisms, including American spellings. Verbs should end in -ise, not -ize eg. recognise.
  • Don’t use the Registered trade mark ® or the Trade Mark symbol ™. This affects the user’s flow of reading.
  • Avoid sentence fragments – see http://grammar.ccc.commnet.edu/grammar/fragments.htm
  • Avoid comma splices - see http://www.everywordcounts.co.uk/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: eg. ‘Cancer can occur anywhere in your oesophagus.’ This should say ‘the oesophagus’.
  • Be sensitive without obscuring the facts.
  • Use an authoritative but friendly style.
  • Write in the present tense – eg. ‘You lie down on a treatment couch and the 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. 

You can see more words and phrases on the plain English Campaign list of alternative words at:: http://www.plainenglish.co.uk/files/alternative.pdf

  • Affected (as in affected lymph nodes) – cancer in one lymph node
  • 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 – use "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 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

Detailed style guide - A to Z

Get guidance on specific details of style related to cancer information.

'A' or 'an'. We don't use 'an' before words beginning with 'h', unless the 'h' is silent eg '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 (apart from eg. instead of for example). If we do, we don't use full stops between letters in abbreviations.

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 eg NICE not N.I.C.E. Spell out in full on first use, with abbreviation in brackets following. Subsequently, use abbreviation. We do not use an apostrophe after a plural abbreviation eg GPs not GP's.

Adviser not advisor (eg financial adviser).

Alveoli are tiny air sacs (not sacks)

Bloodstream is all one word.

Breastfeeding is all one word.

Breastbone is one word.

CancerHelp UK is always written as seen here. NB we are no longer using the name in site content, but referring to 'our' information. The site should now be referred to as 'Cancer Research UK's patient information.

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

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

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

Chemoradiotherapy – we use this term rather than chemoradiation. Chemoradiation is used in North America. But chemoradiotherapy is the preferred term in the UK.

Contact details. Put the address first, followed by phone, website and email. Use Phone instead of Tel. Email doesn't have a hyphen. Website should be all one word. Don’t include either the http:// at the front of the web address, nor any extra code at the end, such as index.html. If you are in any doubt about what will work, try loading the site.

Dietician / Dietitian – we use 'dietitian' as this is the accepted version in the UK.

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

Drug names. Brand names always take a capital letter and generic names don't eg. Panadol, paracetamol. For drugs yet to be named eg 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 the health world. Add other options in brackets in the title or content. We don’t use the registered trade mark symbol when mentioning brand names as it interferes with flow of reading for a lay person.

Examples. Use ‘for example, … and not eg. 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'.

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 now our accepted colloquialism for oesophagus. Younger people are not familiar with 'gullet'. Also include oesophagus for clarity.

Gay – use this term and not homosexual.

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 parentheses – eg. Insulin-like growth factor 1 (IGF1). Generally gene symbols don’t contain punctuation such as hyphens.

Conventionally, symbols for genes are italicised (e.g., IGF1) whereas symbols for proteins are not italicised (eg. 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).

Hyphens. 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. Eg anti angiogenic, not antiangiogenic; anti inflammatory, not antiinflammatory.

Exceptions to this policy are acronyms with an accepted form that includes a hyphen: drug regimens (eg R-CHOP), and some drugs or drug targets that are acronyms (eg G-CSF and PARP-1). 

Intra peritoneal (IP) is 2 words.

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.

Long term doesn’t have a hyphen.

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

Generally ‘may’ suggests a greater possibility that something might happen or is possible than ‘might’.

Mouth care is 2 words.

MRI is an MRI 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'.

Neo adjuvant should be written as 2 separate words as it makes it easier to read.

Non Hodgkin lymphoma is not hyphenated.

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

When writing about proportions use natural frequency (eg. 1 out of 10 people) as well as percentages (10%). Many people find this easier to understand. Eg. More than 1 in 10 people (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 eg 2%.

Always use commas for numbers over 999 eg 1,000.

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.

Painkillers should be one word.

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

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

Post menopausal is two words.

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

Premenopausal does not have a hyphen and is one word.

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 eg lymphocytic (pronounced lim-fo-sit-ik). Try not to use real words as part of the phonetic spelling as it can confuse eg 'in-juicy-bull' for inducible.

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

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 ("). 

Radio waves is 2 words (not radiowaves).

Risk communication. All risk information should be presented as natural frequency eg. '1 in X'. We also generally put the percentage in brackets in an appropriate place in the same sentence. For eg About 1 in 5 people (20%) are diagnosed with stage 4 XXX cancer.

Registered trademark - we don’t use the registered trade mark symbol when mentioning drug names as it interferes with reading for a lay person.

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

Short sentences – 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', ie 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.

Synthetic – don't use this term but use 'man made' instead.

trans is a common medical prefix. We write this as two words, without hyphens eg trans rectal, trans dermal.

Trade mark symbol - we don’t use the registered trade mark symbol when mentioning drug names because it interferes with reading for a lay person.

Voice box is 2 words.

x-ray has a hyphen and a lower case x.

Information and help

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