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Am Fam Physician. 2023;107(3):303-304

Author disclosure: No relevant financial relationships.

Adnexal and ovarian masses (including cysts) are common and may require surgery. The U.S. Food and Drug Administration has approved the Risk of Ovarian Malignancy Algorithm (ROMA) test to assess the presurgical likelihood of ovarian cancer in an adult with an ovarian mass for whom surgery is planned. This test combines two serologic biomarkers (human epididymis protein 4 and cancer antigen 125) with menopausal status to produce a numerical score that identifies patients as having low or high risk. Two other multimarker serum tests (OVA1 and Overa), each of which checks for five serum markers, have also been approved by the U.S. Food and Drug Administration for the same indication.

The American College of Obstetricians and Gynecologists recommends that the risk of malignancy be evaluated before surgery because outcomes are improved when patients with cancer have surgery performed by a gynecologic oncologist.1

TestIndicationPopulationCost*
ROMAAssesses likelihood of ovarian cancer in patients with planned surgeryPatients older than 18 years with an adnexal mass who have not yet been referred to an oncologist$260
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This series is coordinated by Natasha Pyzocha, DO, contributing editor.

A collection of Diagnostic Tests published in AFP is available at https://www.aafp.org/afp/diagnostic.

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