Abstract
Introduction: Ovarian cancer accounts for four percent of all cancer in women worldwide. It is considered as the silent killer, because symptoms do not develop until the disease reached advanced stages. Majority of women are diagnosed at advanced stages when prognosis is poor. This study was carried out with an aim to find out association of Symptom Index with ovarian cancer.
 Methods: A hospital based case control study was conducted over one year in department of Obstetrics and Gynecology, TUTH, Kathmandu. All patients visiting to Gynecology OPD or admitted to Female Surgical Ward with histopathology confirmed ovarian cancer were included. Age matched women with benign ovarian tumor at the ratio of 1:2 were taken as controls. All women were inquired regarding the occurrence of eight symptoms associated with ovarian cancer. A symptom index was considered positive if any of those symptoms occurred >12 times per month but were present for <1 year.
 Results: There were 30 cases and 60 controls. Twenty-nine (96.7%) cases and 56 (93.4%) controls presented with abdominal pain but it was not statistically significant. However, abdominal bloating in 56.7% vs 8.3% [OR-14.4 (4.5-46.2)], increased abdominal size in 40% vs 11.6% [OR- 5.04 (1.7-14.8)], difficulty in eating in 30% vs 1.7% [OR- 25.3 (3.02-211.7)], and feeling full in 23.3% of vs 1.7% [OR-17.9 (2.09-154.1)], all were statistically significant.
 Conclusions: Symptoms are present in a significant number of women with ovarian cancer. So, evaluating women with specific symptoms of recent onset helps to make the early diagnosis of ovarian cancer.
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