ROMA (Risk of Ovarian Malignancy Algorithm) Calculator
Enter lab values to estimate ROMA score. Use HE4 in pmol/L and CA125 in U/mL.
What Is the ROMA Index?
The ROMA index (Risk of Ovarian Malignancy Algorithm) is a clinical calculation that combines two tumor markers, HE4 and CA125, along with menopausal status, to estimate the likelihood that an ovarian mass is malignant. It is commonly used to support triage decisions and specialist referral planning.
ROMA is not a stand-alone diagnosis. Instead, it is one piece of information that works best when interpreted together with imaging findings, history, physical exam, and physician assessment.
How This ROMA Index Calculator Works
This page uses a standard logarithmic ROMA model with different equations for premenopausal and postmenopausal patients.
1) Predictive Index (PI)
Postmenopausal: PI = -8.09 + 1.04 × ln(HE4) + 0.732 × ln(CA125)
2) ROMA Percentage
3) Interpretation Thresholds Used Here
- Premenopausal: High risk if ROMA ≥ 11.4%
- Postmenopausal: High risk if ROMA ≥ 29.9%
Input Requirements
To get a meaningful result, make sure your lab values are in the correct units:
- HE4: pmol/L
- CA125: U/mL
- Menopausal status: premenopausal or postmenopausal
Entering values in the wrong units can significantly distort the output.
How to Use the Result in Practice
Low-risk ROMA result
A low-risk score may suggest a lower probability of ovarian malignancy, but it does not rule it out. Follow-up still depends on ultrasound findings, symptoms, and physician direction.
High-risk ROMA result
A high-risk score suggests increased concern for malignancy and usually supports expedited specialist evaluation, often with gynecologic oncology input.
Important Limitations
- ROMA performance depends on assay method and laboratory quality.
- Cutoffs may vary by institution, manufacturer, or regional guideline.
- False positives and false negatives can occur.
- ROMA should not replace pathology, imaging, or specialist assessment.
Quick Example
If a postmenopausal patient has HE4 = 120 pmol/L and CA125 = 80 U/mL, the calculator can estimate ROMA and compare it to the postmenopausal cutoff. This does not diagnose cancer; it helps stratify risk for care planning.
FAQ
Is ROMA a cancer test?
No. It is a risk stratification tool, not a definitive diagnostic test.
Can I use this for self-diagnosis?
No. Results must be interpreted by qualified clinicians in context.
Why do menopausal groups use different formulas?
Biomarker behavior differs by menopausal status, so separate coefficients improve model calibration.
Final Note
This ROMA index calculator is designed to be fast, clear, and clinically relevant for educational and workflow support use. Always verify thresholds and interpretation rules with your lab platform and local protocol.