International Journal of Science and Healthcare Research Vol. 8; Issue: 2; April-June 2023 Website: ijshr.com Original Research Article ISSN: 2455-7587 International Journal of Science and Healthcare Research (www.ijshr.com) 91 Volume 8; Issue: 2; April-June 2023 Predictive Value of Symptom Index for Early Detection of Ovarian Cancer Dr. Aliya B Aziz 1 , Dr. Uzma Chishti 2 , Dr. Nosheen Sikandar Baloch 3 , Dr. Falak Naz Dahar 4 , Dr. Rozilla Sadia Khan 5 1 Associate Professor, Dept. of Obstetrics and Gynecology, Aga Khan University Hospital, Karachi, Pakistan 2 Assistant Professor, Dept. of Obstetrics and Gynecology, Aga khan University Hospital, Karachi, Pakistan 3 Fellow Gynae-oncology, Dept. of Obstetrics and Gynecology, Aga khan University Hospital, Karachi, Pakistan 4 Fellow Gynae-oncology, Dept. of Obstetrics and Gynecology, Aga khan University Hospital, Karachi, Pakistan 5 Associate Professor, Dept. of Obstetrics and Gynecology, Aga khan University Hospital, Karachi, Pakistan Corresponding Author: Dr. Aliya B Aziz DOI: https://doi.org/10.52403/ijshr.20230211 ABSTRACT Objective: Although symptom-based screening has a positive role in identifying women at risk, it’s yet to be validated as screening tool. The present study aimed to validate the ovarian cancer symptom index in Pakistani population. Methods: From June 2019-December 2020, presenting symptoms were prospectively recorded in patients with ovarian cancer (n=70) and benign ovarian tumor (n=140) using Goff’s questionnaire. Results: Symptoms such as unable to eat normally, feeling full quickly, weight loss, increased abdomen size and postmenopausal bleeding were reported more frequently among the cancer group (p<0.05). Symptoms including feeling full quickly, increased abdominal size and patients' age were independent predictors of cancer. The sensitivity, specificity, positive and negative predictive value, of symptom index were found to be 31.43%, 79.29%, 43.13%, and 69.81%, respectively. Conclusion: This study confirms that specific symptoms were useful in diagnosing women with ovarian cancer. Low sensitivity and specificity of the symptom index limit its use as an independent screening method. Nonetheless, with further validation it can be included for screening in clinical settings. Keywords: ovarian cancer, symptom index, diagnosis, predictive value INTRODUCTION Amongst the many gynecological malignancies reported worldwide, ovarian cancer is the most noxious one causing at least 140,000 deaths annually (1). In Pakistan, it is the second most common female cancer with a prevalence of 13.6% (2, 3). Five-year survival rate of cancers confined only to the ovaries is 70% to 90% compared to advanced disease (15–30%). Unfortunately, due to the deeper anatomic location, most cancers (60%-70%) are detected at a later stage, and only 19% of ovarian cancer cases are diagnosed in the initial stages (4-8). Although previously regarded as a "silent killer “due to its insidious nature and late diagnosis, the results of several case studies have proven otherwise. These studies infer that ovarian cancer causes a distinct pattern and timing of symptoms. Given the deeper anatomic locations, overlapping symptoms, and absence of high-quality, standard screening techniques, ovarian cancer remains a diagnostic challenge (4, 5, 8). With limited available data on the efficacy or potential morbidity of ovarian cancer screening tools in the asymptomatic general population, currently, routine screening is not recommended. Amongst many screening approaches, ovarian symptom index is currently the most commonly used