ROMA Index - OVARIAN MALIGNANCY RISK ALGORITHM, in Navi Mumbai

ROMA (Risk of Ovarian Malignancy Algorithm) combines serum HE4 and CA125 levels with menopausal status to estimate the probability of epithelial ovarian cancer. It uses logistic regression: premenopausal PI = −12.0 + 2.38·ln(HE4) + 0.0626·ln(CA125); postmenopausal PI = −8.09 + 1.04·ln(HE4) + 0.732·ln(CA125). ROMA% = exp(PI)/(1+exp(PI))×100; cutoffs: ≥11.4% (pre), ≥29.9% (post) indicate high risk.

ROCA (Risk of Ovarian Cancer Algorithm) is a statistical model that interprets serial CA‑125 blood levels over time to detect patterns suggestive of ovarian cancer. Using age and a Bayesian change‑point approach, it estimates individualized risk and classifies results to prompt repeat testing, transvaginal ultrasound, or specialist referral. It can identify rising trends earlier than a single cutoff, but isn’t endorsed for routine population screening.

ROMA (Risk of Ovarian Malignancy Algorithm) uses serum HE4 and CA125 plus menopausal status. Compute the predictive index (PI): premenopausal PI = -12.0 + 2.38 × ln(HE4) + 0.0626 × ln(CA125); postmenopausal PI = -8.09 + 1.04 × ln(HE4) + 0.732 × ln(CA125). Convert to ROMA% = exp(PI)/(1+exp(PI)) × 100. Cutoffs: ≥11.4% (premenopausal) or ≥29.9% (postmenopausal) indicate high risk.

RMI is calculated as RMI = U × M × CA125. Ultrasound score (U): 0 for no suspicious features, 1 for one feature, 3 for two or more (features: multilocularity, solid areas, bilaterality, ascites, metastases). Menopausal status (M): 1 if premenopausal, 3 if postmenopausal. Multiply by serum CA125 (U/ml); RMI ≥200 commonly indicates high malignancy risk.

A high ROMA score indicates an increased probability of epithelial ovarian malignancy. It’s calculated from blood markers (HE4 and CA125) plus menopausal status. A high result usually prompts further evaluation—imaging and referral to a gynecologic oncologist—but is not diagnostic by itself. Clinical assessment and additional tests are needed to confirm or exclude cancer.

The ROMA (Risk of Ovarian Malignancy Algorithm) scale combines blood levels of CA‑125 and HE4 with menopausal status to estimate a woman’s likelihood of having epithelial ovarian cancer. It yields a numeric risk score used to classify patients as low- or high-risk preoperatively and helps guide referral and management. It is an adjunct to imaging and clinical assessment, not a definitive diagnostic test.