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Risk of Ovarian Malignancy Algorithm
2012618
Ordering Recommendation

Assess cancer risk, particularly epithelial cell ovarian cancer, in pre- and postmenopausal women who present with an adnexal mass. Not intended as a screening, stand-alone, or tumor-monitoring assay. Tumor monitoring using HE4 and/or CA 125 should be ordered separately.

Mnemonic
ROMA
Methodology
Quantitative Enzyme Immunoassay, Electrochemiluminescent Immunoassay
Performed
Thu, Sun
Reported
1-8 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
 
Collect
Plain red or serum separator tube (SST). 
Specimen Preparation
Allow specimen to clot completely at room temperature.  Transfer 1.5 mL serum to an ARUP Standard Transport Tube.  (Min: 1 mL) 
Storage/Transport Temperature
Frozen. 
Unacceptable Conditions
Hemolyzed specimens. 
Remarks
 
Stability
Ambient: 4 hours; Refrigerated: 72 hours; Frozen: 9 months 
Reference Interval
By Report
Interpretive Data
The Risk of Ovarian Malignancy Algorithm (ROMA) combines the results of HE4, CA125, and menopausal status into a numerical score. If the patient is premenopausal, then a ROMA score of less than 1.31 is consistent with a low likelihood of having a malignancy on surgery. If the patient is postmenopausal, then a ROMA score of less than 2.77 is consistent with a low likelihood of having a malignancy on surgery.

ROMA is intended to aid in assessing whether a premenopausal or postmenopausal woman who presents with an ovarian adnexal mass is at high or low likelihood of having malignancy on surgery. ROMA is indicated for women who meet the following criteria: over age 18; ovarian adnexal mass present for which surgery is planned, and not yet referred to an oncologist. ROMA must be interpreted in conjunction with an independent clinical and radiological assessment. The test is not intended as a screening, stand-alone or tumor-monitoring assay. Tumor monitoring using HE4 and/or CA125 should be ordered separately.

Note
CPT Code(s)
86304; 86305 (Alt code:81500 (MAAA))
Components
Component Test Code*Component Chart NameLOINC
2012619ROMA, Premenopausal
2012620ROMA, Postmenopausal
2012621ROMA Cancer Antigen 125
2012622ROMA Human Epididymis Protein 4
2013036ROMA Interpretation
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases