‘Ignoring data of 44m women in India, 31m in China not global consensus’
Mansoor Peer
Srinagar, May 20: Indian medical researchers are challenging a globally proposed renaming of Polycystic Ovary Syndrome (PCOS) to Polyendocrine Metabolic Ovarian Syndrome (PMOS), arguing that it ignores the world’s largest patient populations, oversimplifies the disease, and reflects Western-centric scientific decision-making rather than true global consensus.
Professor (Dr) Mohd Ashraf Ganie, National Chief Coordinator of the Indian Council of Medical Research (ICMR) PCOS Task Force and Director of SKIMS, alongside National Principal Investigators Prof Neena Malhotra (AIIMS New Delhi) and Prof Rakesh K. Sahay (Osmania Medical College Hyderabad), have issued a collective objection to the recently proposed renaming published in The Lancet and announced at the European Congress of Endocrinology in Prague.
Prof Ganie said the consensus group, largely led by researchers from regions like Australia (managing approximately 1.5 million women), notably excluded data from India and China, which together represent a combined burden of nearly 75 million patients.
“A decade of study that ignores the data of 44 million women in India and 31 million in China is not a global consensus. The exclusion of our multicentre, 9,000-subject cohort, the largest of its kind, rendered the exercise bereft of the geographic diversity needed for scientific accuracy,” he said.
The scientists maintain that any shift in nomenclature must be led by countries like India and China—the “PCOS capitals” of the world—where the largest and most well-designed studies on the condition have actually been conducted.
Beyond geographic bias, Prof Ganie critiqued the “Ovarian” and “Polyendocrine” terms of the new name. “Despite the attempt to modernise, the new label remains organ-oriented, which ICMR data reveals is clinically inconsistent with the systemic phenotype. In a community-based cohort of 8,993 Indian women, a staggering percentage exhibited normal ovarian morphology. By re-centring the ovary in the title, we are merely polishing a 1935 morphological bias,” he explained.
The researchers warn that “Polyendocrine” risks immediate confusion in primary care settings with distinct multi-glandular disorders such as Multiple Endocrine Neoplasia (MEN) or Autoimmune Polyglandular Syndrome (APS). Notably, hyperandrogenism—the dominant clinical signature of the syndrome—is absent from the new nomenclature, leading to what Prof Ganie describes as “diagnostic dilution.”
The ICMR study has also identified an urgent public health concern by identifying the Pre-PCOS phenotype, revealing that every fourth woman in India is affected by metabolic irregularities. “These women, with abnormal metabolism, are likely to affect the metabolic health of future generations if they conceive,” they warned.
Prof Ganie, Prof Malhotra, and Prof Sahay called for the global community to revisit the process and move toward a truly evidence-based, organ-neutral diagnostic framework.
“If we acknowledge that this is a multifaceted systemic metabolic disorder that demands a holistic, interdisciplinary approach to care, we must be scientifically wise enough to name it as such—metabolically centred, gender-inclusive, and free from the organ-centric biases of the past century. To do otherwise is to reintroduce a new geographic anomaly,” they said.
