Last week a colleague asked the Twittersphere whether endometriosis is a disease, disorder or condition. Always keen to accept a challenge, I went off to investigate. Join me on my journey down the rabbit hole!

Disease, disorder and condition. What’s the difference?

Before looking at endometriosis itself, I investigated the definitions of disease, disorder and condition. The table below shows the entries from two specialised and three general dictionaries. Broadly speaking, while disease is characterised by distinguishing signs and symptoms and affects structure and/or function, disorder focuses on impaired function. Interestingly, the two specialised dictionaries have no entry at all for condition, while the general dictionaries note that, as well as being a synonym for illness, condition refers to a state, often accompanied by a negative modifier, such as ‘poor’.

[click table to enlarge]

¹ Stedman’s Medical Dictionary Online
² Dorland’s Medical Dictionary Online
³ Oxford Dictionary of English
⁴ Oxford English Dictionary
⁵ Merriam-Webster

Three dictionaries define endometriosis as a condition, which is unsurprising because the Greek suffix -osis means state or condition. However, endometriosis is characterised by altered function and structure (with the physiological implications of ectopic oestrogen-dependent tissue) and identifiable signs and symptoms (inflammation, pelvic pain, dysmenorrhea), all of which point to dictionary definitions of disease.

[click table to enlarge]

… by usage

But dictionaries tell only half the story. As translators and editors, we need to know how words are used in real life and adapt our word choices to a specific genre or register. Corpora can help guide those decisions.

In Sketch Engine, I investigated the usage of endometriosis in enTenTen15, a huge web-crawled corpus suitable for work with patient-facing texts. Sketch Engine’s Word Sketch (an overview of collocations sorted by grammatical relations) showed that condition is the most common collocate for endometriosis in sentences that define the term itself, i.e., those that start ‘Endometriosis is…’

To get a picture of academic usage, I built a quick corpus by seeding keywords likely to appear only in academic texts: ‘dysmenorrhea’, ‘infiltrating’, ‘intraoperative’, ‘GnRH’ and ‘stroma’, along with ‘endometriosis’. Returning to Word Sketch with my newly created academic corpus, I discovered that disease is much more common than condition when describing endometriosis.

Collocations for endometriosis in a general vs. academic corpus

Academic corpus: concordance filtered by ‘disease’ to the right of ‘endometriosis’

To see if usage has changed over time, I performed two PubMed searches for articles published in 2010 and 2020 with endometriosis in the title. I counted the instances of disease, disorder and condition in the first 20 abstract snippets that mentioned a definition. The strongest collocation was disease in 2010 and 2020 alike, with condition being somewhat more frequent in 2010 and disorder in 2020.  

The frequency of disease was similar in the two PubMed searches and my academic keyword corpus, accounting for 65-70% of instances mentioned, showing that my quick corpus was indeed representative of academic texts.

Conclusion

Endometriosis is mainly referred to as a disease in academic texts; condition is a valid option when a more value-neutral term is needed for patient-facing and general texts.

Rabbit holes are best avoided when you’re up against a deadline, but ferreting out the facts is oh such fun!