Hot topic: Should we keep renaming diseases?

Thursday June 12 was Global Fatty Liver Day. But until 2018 it was known as International NASH Day – NASH being short for ‘non-alcoholic steatohepatitis’. The name of the awareness day was changed to increase awareness of all types of fatty liver disease, as NASH is just one type – a more serious type – of fatty liver disease. 

Yet more recently there has been a move to rename ‘NASH’ as ‘MASH’ – short for ‘metabolic dysfunction associated steatohepatitis. Likewise, what used to be called NAFLD (non-alcoholic fatty liver disease – a less serious type, but often a precursor to NASH / MASH) has been renamed MASLD (metabolic dysfunction-associated steatotic liver disease). 

The purported reason for this change was to drop the ‘non-alcoholic’ prefix. This was originally used to distinguish the diseases from those caused by excess drinking. However, it was deemed vague and unscientific – categorisation by exception rather than precision. 

But the other reason was to avoid use of the f-word – fatty – because of its pejorative undertones and possible implications of blame. 

The name of the awareness day and the diseases it represents have therefore been moving in opposite directions and now clash.  

Should June 12 now be renamed Global MASLD Day? Or (more memorably) Global MASH Day? 

This pickle demonstrates the problem of renaming diseases to reflect our growing scientific understanding, or to be kinder to patients.  

If we don’t rename them, we are left with scientifically inaccurate descriptions that can end up stigmatising patients. 

But if we do, we risk nobody knowing what we are talking about. 

There’s no right or wrong answer here – but name changes do need to be handled with care. 

A positive example of a name change was the renaming of monkeypox as mpox, a decision taken by the World Health Organization in 2022 after complaints the original was confusing and potentially racist. It had been named monkeypox in 1970 after the disease was found in captive monkeys.  

The two names were officially used in tandem for the following year, allowing the new name to bed in. The fact the successor was a clear contraction of the original helped too.