Ask Athena: How Do I Correctly Apply British vs. American Spelling?

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Ask Athena is Science Editor’s advice column for your most challenging publishing and editing questions. Submit your questions to 

Dear Athena,

I have two questions, the answers for which I can’t locate in the AMA Manual of Style. Should we use the spelling Programme or Program in the following? 

UN Joint Global Programme on Cervical Cancer Prevention and Control 

Likewise, should we use Centres or Centers in the name Directory of Radiotherapy Centres?

—Looking Across the Pond


Dear Looking Across the Pond,

When it comes to English-language spellings of institution names, a widely accepted rule of thumb is to follow the official spelling of that institution rather than impose house style on the spelling. The quickest and most accurate means of determining the official spelling is to consult the institution’s website. For the two institutions in question, an online search confirms that the British spellings Programme and Centres are used in the official names of these institutions—so these spellings should be applied whenever either institution is mentioned, even if your house style is to apply U.S. spelling.

Similar exceptions should be made for published material, both in text and in an end reference. For example, if The Lancet article “Study of Mirtazapine for Agitated Behaviours in Dementia (SYMBAD): A Randomised, Double-Blind, Placebo-Controlled Trial”1 were to be cited in a journal that prefers U.S. spelling, the British spellings Behaviours and Randomised would need to be retained in the citation nonetheless to preserve the accuracy of content that was formally published in a UK-based journal. Similarly, a citation of the article “The Development of a Standardized Neighborhood Deprivation Index” in The Lancet would mandate the U.S. spellings of the words Standardized and Neighborhood (as opposed to the British spellings Standardised and Neighbourhood) given that these were the spellings used in the article’s original publication in the U.S.-based Journal of Urban Health.2

Note, however, that the aforementioned exceptions should generally be limited to titles and institutional names within a given article—meaning if your house style requires that you enforce U.S. spelling, you should continue to apply those rules elsewhere rather than apply nonstandard spellings globally to achieve consistency. For example:

This year’s program will include a presentation by a representative from the UN Joint Global Programme on Cervical Cancer Prevention and Control.

The Directory of Radiotherapy Centres is at the center of a collaborative effort to advance radiotherapy techniques.

Finally, be mindful that the same principle applies to other grammar rules. For example, the AMA Manual of Style cites a preference for the nonpossessive form of eponymous diseases and disorders, which means that Alzheimer disease (rather than Alzheimer’s disease) would be the appropriate form in a document that adheres to AMA style; however, because the Alzheimer’s Association uses the possessive form in its official name, any references to it in that same document should retain the possessive form.3 Similarly, hyphenation should not be altered in institution names or titles if doing so alters the official name or title. For example, when referencing the AIDS Education & Training Center Program’s Non-occupational Post-exposure Prophylaxis (nPEP) Toolkit, Merriam-Webster disciples may be tempted to uncouple the prefixes “Non-” and “Post-” from their hyphens; however, the hyphens must be retained to reflect the official name of the toolkit,4 regardless of whether the unhyphenated forms nonoccupational and postexposure appear in different contexts elsewhere the same document. 

In short: When in doubt about the proper spelling of an entity’s name, look to the entity itself.


References and Links

  1. Banerjee S, High J, Stirling S, et al. Study of mirtazapine for agitated behaviours in dementia (SYMBAD): a randomised, double-blind, placebo-controlled trial. Lancet. 2021;398:1487–1497.
  2. Messer LC, Laraia BA, Kaufman JS, et al. The development of a standardized neighborhood deprivation index. J Urban Health. 2006;83:1041–1062.
  3. Gregoline B. Eponyms. In: Christiansen SL, Iverson C, Flanagin A, Livingston EH, Fischer L, Manno C, Gregoline B, Frey T, Fontanarosa P, Young RK, editors. AMA manual of style: a guide for authors and editors. 11th ed. New York: Oxford University Press; 2020. p. 915−918.
  4. Non-occupational post-exposure prohylaxis (nPEP) toolkit. AIDS Education & Training Center Program; 2022. [accessed March 5, 2022].


Answers to Ask Athena questions are a group effort by members of the CSE Education Committee.