Epithelial ovarian cancer risk assessment - ROMA

What is the ROMA test?

The ROMA test is an algorithm that assesses the likelihood of ovarian cancer risk in women with pelvic tumors.

Ovarian cancer is one of the most common cancers with a very high mortality rate in women. Initially, the disease develops without visible symptoms, which makes it difficult to detect the cancer at an early stage of its development.

The main cause of mortality from ovarian cancer is asymptomatic until late stages, when the cancer begins to spread beyond the ovaries.

For this reason, 70%-75% of ovarian cancer cases are discovered incidentally.

Patients usually visit a gynecologist because of abdominal pain. They may also report nonspecific symptoms, such as:

• indigestion
• flatulence
• nausea
• vomiting
• no appetite

An absolute indication for further diagnostics is the occurrence of:

• painful pressure on the bladder
• pain when urinating
• vaginal bleeding

ROMA algorithm ( Risk of Ovarian Malignancy Algorithm ) is calculated on the basis of the determined concentrations of two tumor markers CA125 and HE4 and taking into account the woman's menopausal status. On its basis, women can be classified into a high or low risk group for developing ovarian cancer. Performing the determination of both markers at the same time and calculating the ROMA value increases the diagnostic value of these tests. The role of ROMA in the detection of early forms of ovarian cancer is particularly emphasized.

The ROMA test is not recommended for the diagnosis of women under the age of 18, previously treated for cancer or currently undergoing chemotherapy.

When should a ROMA test be performed?

The ROMA test is performed to assess the risk of ovarian cancer in women with existing pelvic tumors.

Depending on the results of this examination and their interpretation by the attending physician (in conjunction with information provided by other examinations and an assessment of the overall clinical status of the patient), a decision may be made on possible further management and type of treatment (including surgery).

Who should perform the ROMA test?

Ovarian cancer may be associated with a genetic predisposition, therefore women who have been diagnosed with the disease in close relatives are at greater risk of developing this cancer.

The ROMA test is usually ordered by a doctor after finding disturbing symptoms or other test results that could indicate the presence of a neoplastic process in the ovary.

Symptoms that should urgently refer the patient to the doctor are:

• pelvic pain
• enlargement of the abdominal circumference
• constipation, bloating
• pain and a feeling of pressure in the lower abdomen
• painful pressure on the bladder, pain when urinating
• a feeling of fullness in the belly
• vaginal bleeding unrelated to the menstrual cycle
• symptoms resulting from the tumor's pressure on the urinary and digestive systems