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The ROMA test is an effective method of diagnosing ovarian cancer. This cancer is a very insidious disease that takes a long time to develop in a woman’s body without showing any symptoms. Therefore, when the disease is detected, it is too late for treatment. Each year, ovarian cancer is diagnosed in approximately 3 women. It mostly attacks young women.
The ROMA test plays a very important role in the diagnosis of ovarian cancer. The disease does not give any symptoms for a long time, so it is usually diagnosed too late. In this case, regular examinations are essential, and the ROMA test is the most effective way to diagnose ovarian cancer.
What is the ROMA test and who should take it?
The name of the ROMA test stands for “Risk of Ovarian Malignancy Algorithm”. It is an extremely effective and modern method that allows the differentiation of changes in a woman’s ovaries. It is not only a diagnostic method, but also enables the selection of an appropriate treatment method and a quick start of treatment.
Ovarian cancer is an insidious disease that develops in a woman’s body for years without showing any symptoms. When a woman begins to feel the effects of her developing disease, it is usually too late for treatment. Even the first symptoms of ovarian cancer are not characteristic enough to take appropriate steps to diagnose it.
Most often these are stomach or liver pains, which we go to the GP or gastroenterologist. After taking an interview, he or she can determine the risk of ovarian cancer and refer the patient to a gynecologist.
The gynecologist performs basic transvaginal examinations and also orders other diagnostic tests, such as MRI or tomography. If they show changes in the ovaries, the patient is referred for the ROMA test. The test should not only be performed on women under 18 years of age. Another contraindication is chemotherapy or a previous cancer.
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What is the ROMA test?
The ROMA test is a new diagnostic method by which it is possible to determine if the lesion on the ovary is malignant. The test consists in taking CA 125 and HE4 markers. The test result is also assessed on the basis of the statistical risk of developing malignant ovarian cancer. They are calculated on the basis of a mathematical algorithm and the result is given as a percentage.
This examination allows the patient to be classified into the appropriate group and undergo appropriate treatment. It is also possible that the patient will be referred for further diagnostics.
The results are divided into two categories:
- for premenopausal women – the result of 7,4% or more is a high risk of developing ovarian cancer;
- for postmenopausal women – a result of 25,3% or more shows a high risk of developing ovarian cancer.
During the test, electrochemiluminescence is used. The material used during the test is venous blood taken from a vein in the arm. It is best to donate blood for testing in the morning around 7-9. The results are available the very next day. The examination costs about PLN 120. There is no need to prepare for the examination and the woman does not need to fast. In summer, it is advisable to drink a glass of water approx. 30 minutes before blood sampling.
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How to prepare for the ROMA test?
You should not prepare yourself for the examination. You should also not be fasting. The determination of tumor markers is performed on a blood sample taken from the patient. Then, math calculations are made that take into account whether the woman is pre-menopausal or post-menopausal.
How should the results of the ROMA test algorithm be interpreted?
The norms for the ROMA test are set depending on whether the woman is pre-menopausal or postmenopausal.
The results are interpreted on the basis of the method of marking the markers and the type of apparatus used for the test. It’s good to know that both too low and too high a result can mean a higher risk of cancer.
For premenopausal women, a low risk of developing ovarian cancer is less than 11,4%. If the result is greater than or equal to 11,4%, it means a high risk of developing the disease. Some laboratories indicate a cutoff value of 7,4%.
For postmenopausal women, 29,9% is considered a low risk score. If the result is greater than or equal to 29,9%, it means a high risk of ovarian cancer. According to some sources, the cutoff is 25,3%.
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What are the HE4 and CA 125 markers?
The HE4 and CA 125 markers play an important role in the diagnosis of ovarian cancer, which is a very dangerous and insidious disease that also affects young women.
The ROMA test is very effective due to the fact that this method combines several methods used so far. It includes:
- determining the concentration of the CA 125 marker;
- determination of the concentration of the HA4 marker – this marker is the fourth subfraction of the human epididymal cell protein;
- statistical analysis – it is carried out with the use of a mathematical algorithm specially developed for this purpose, which, based on the collected information, allows to assess the risk of specific diseases.
Before the development of the ROMA test, the risk of developing ovarian cancer was determined on the basis of the concentration of the CA 125 marker only. It turned out, however, that the result of this test was imprecise, because the amount of this marker in the blood also increased in tumors of other reproductive organs. Therefore, the result did not give an unequivocal answer.
Over time, scientists discovered that there was a second ovarian cancer marker, which they called HE4. This marker appears in the blood much earlier than CA 125, which makes it possible to diagnose the disease in stage I or II. By taking into account the concentration of both of these markers, accurate diagnosis can be made. By assessing the concentration of these markers, the test has a much greater sensitivity and specificity at the same time.
What are the contraindications and indications for the ROMA test?
Contraindication to the ROMA test is:
- age under 18;
- previous neoplastic disease;
- undergoing chemotherapy.
The indication for the ROMA test is:
- disturbing ailments in the lower abdomen, e.g. flatulence, constipation, fatigue, pain, feeling of fullness. In addition, the indication may be malaise, loss of appetite, weakness, a feeling of pressure and pressure in the lower abdomen, pain when urinating, or vaginal bleeding;
- pelvic lesions – especially undefined structures suggesting neoplasm;
- planned surgical treatment of diagnosed changes;
- qualifying the patient for oncological treatment.
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