ROMA Index Calculator (Risk of Ovarian Malignancy)
Estimate the risk of epithelial ovarian cancer in patients with a pelvic mass using CA125 and HE4 biomarkers. Features separate algorithms for pre-menopausal and post-menopausal status.
About
The Risk of Ovarian Malignancy Algorithm (ROMA) combines two serum biomarkers, HE4 and CA125, with menopausal status to stratify patients with an adnexal mass into high or low risk groups for epithelial ovarian cancer. HE4 is often more sensitive than CA125 for early-stage disease and less prone to elevation in benign gynecological conditions like endometriosis.
This tool applies the specific logistic regression coefficients derived from the Moore et al. multicenter trials. Accuracy depends heavily on the correct selection of the patient's menopausal status, as hormonal environments significantly alter biomarker baselines.
Formulas
The algorithm calculates a Predictive Index (PI) which is then converted to a probability percentage.
Predictive Index (Pre-menopausal):
PI = −12.0 + 2.38 × ln(HE4) + 0.0626 × ln(CA125)
Predictive Index (Post-menopausal):
PI = −8.09 + 1.04 × ln(HE4) + 0.732 × ln(CA125)
ROMA Probability (%):
exp(PI)1 + exp(PI) × 100Reference Data
| Patient Group | ROMA Score Cutoff | Risk Stratification |
|---|---|---|
| Pre-menopausal | ≥ 11.4% | High Risk of Malignancy |
| Pre-menopausal | < 11.4% | Low Risk |
| Post-menopausal | ≥ 29.9% | High Risk of Malignancy |
| Post-menopausal | < 29.9% | Low Risk |