According to J Gynecol Oncol, December 2009: Symptom index screening for ovarian cancer: a hospital-based survey study (by Mi-Kyung Kim et al.) Ovarian cancer is one of the common gynecologic malignancies, with high mortality rate and poor prognosis because of insidious onset, early undetectable and easily metastasized, and most of them are already at advanced stage when detected. To improve the survival rate of ovarian cancer, some screening methods have been found to help early diagnosis of ovarian cancer, but they are not satisfactory, such as CA125 and transvaginal ultrasonography, which are not sensitive and specific enough. Mi-Kyung Kim et al. from Seoul, Korea, conducted a questionnaire survey on 116 patients with epithelial ovarian cancer and 209 control women to analyze the relationship between eight symptoms – pelvic pain/abdominal pain, urinary urgency/frequency, increased abdominal girth/distension, poor appetite/sense of fullness, and frequency and duration of symptoms – and early ovarian cancer. The results revealed that 65.5% of ovarian cancer patients had positive symptom index, which was significantly higher than the control group. Statistical analysis revealed that symptom index scores could be used to independently predict ovarian cancer (p<0.001; OR, 10.51; 95% CI, 6.14 ~17.98). In particular, urinary urgency/frequency and increased abdominal girth/distension were significant predictors. The sensitivity and specificity of the symptom index for the diagnosis of ovarian cancer were 65.5% and 84.7%, respectively, and the sensitivity increased to 85.3% and the specificity decreased to 59.5% when combined with CA125, and transvaginal ultrasound could be used for the second stage of screening. This study suggests that clinicians should be alert when patients complain of recent persistent abdominal, gastrointestinal or urinary symptoms and perform pelvic examinations to help detect ovarian cancer at an early stage.