ROMA index (HE4 and CA-125)
Quick answer: The ROMA index combines HE4 and CA-125 blood results with menopausal status to estimate the chance that an ovarian mass is cancer. It is used when a woman has an ovarian or pelvic mass, to help decide on further tests and referral.
- SampleBlood
- TakesAbout 5 minutes
- Before the testNo special preparation is usually needed; tell staff whether you have reached menopause.
How the test is done
- 1Blood is drawn from a vein in your arm
- 2The lab measures HE4 and CA-125 from the same sample
- 3Your menopausal status is noted on the form
- 4A formula combines these into a ROMA value and risk group
What your results can mean
Reading your report
Results are reported as a lower-risk or higher-risk score and are not a diagnosis; discuss them with your doctor.
If the result is outside the usual range
A high ROMA value can point to a higher chance that an ovarian mass is cancer, which can lead to referral to a gynaecological cancer specialist. A low value suggests a lower chance but does not rule out cancer.
Who usually has this test
Women with an ovarian mass on a scan who are being assessed before surgery.
Risks and aftercare
Bruising is possible; your gynaecologist will explain what the score means for your planned care.
Names and options
Also called: ROMA, risk of ovarian malignancy algorithm, HE4 ROMA
Listed by the hospital as
- HE4 (ROMA INDEX), SERUM
Questions about this test
Why does menopausal status matter for ROMA?
HE4 and CA-125 behave differently before and after menopause. The formula and cut-offs are adjusted for this.
Does a high ROMA mean I have ovarian cancer?
No, it means a higher chance, and many women with a high value turn out to have harmless masses. Surgery and tissue testing give the diagnosis.
Can ROMA replace an ultrasound scan?
No. ROMA is used together with ultrasound findings, not instead of them.
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The hospital is open 24 hours. Call before you come to check the timing for your scan or sample collection.
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This page explains each test in general terms so you know what to expect. It is not medical advice: your doctor decides which tests you need and what your results mean. Reference ranges differ between laboratories. Updated 4 November 2026.