ABSTRACT
Ovarian cancer often goes undiagnosed or misdiagnosed in the early stages. The present study aimed to validate a modified version of the Goff Symptom Index [GSI] in an Indian population. This prospective case-control study was conducted between July 2010 and June 2012 in a university hospital in Manipal, Karnataka, India. A total of 305 inpatients admitted for ovarian pathology investigations and outpatients undergoing routine gynaecological check-ups were included in the study. The modified GSI [MGSI] was used to investigate the presence, severity, frequency and duration of 10 ovarian cancer symptoms on a scale of 1-5. Four additional symptoms were included with those of the original GSI [two symptoms from a previous MGSI and two new symptoms]. Patients were regarded as positive for ovarian cancer if symptoms occurred >12 times per month and time since onset was <1 year. Histopathology confirmed the diagnosis of ovarian tumours. A total of 13 patients were excluded. The final sample [n = 292] was divided into a test group [n = 74] and a control group [n = 218] based on histopathology. Within the controls, 144 women were found to have benign tumours. The MGSI was positive in 71.6% of the test group as opposed to only 11.5% of the control group. The addition of two symptoms [loss of appetite and weight] to the GSI increased the test's sensitivity from 71.6% to 77% without compromising specificity [88.5%].Based on these findings, the addition of two new symptoms [loss of appetite and weight] to the GSI is proposed in order to increase the test's sensitivity. However, the addition of urinary symptoms to the GSI requires further validation