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Combining Numerals and Words 

Numbers and Percentages

Stephen J. Lurie

and Margaret A. Winker

Use a combination of numerals and words to express rounded large numbers and consecutive numerical expressions. Rounded large numbers, such as those starting with million, should be expressed with numerals and words.The disease affects 5 million to 6 million people. [Note that the word million is repeated to avoid ambiguity.] The word million signifies the quantity 106, while billion signifies the quantity 109. Although billion has traditionally signified 1012 (1 million million) in Britain, many British medical journals now use billion to indicate the quantity 109. A number may be expressed in million rather than billion if the latter term

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