What Is the HE4 Blood Test?
HE4 stands for human epididymis protein 4. It is a protein that can be measured in the blood and may be elevated in certain types of ovarian cancer.
Doctors sometimes use HE4 alongside another ovarian tumor marker called CA-125.
These markers provide different information, but neither can diagnose ovarian cancer on its own.
An elevated HE4 level does not automatically mean that cancer is present.
What Is the ROMA Test?
ROMA stands for Risk of Ovarian Malignancy Algorithm.
It is not a separate substance measured in the blood. Instead, it combines three pieces of information:
- HE4 blood test results.
- CA-125 blood test results.
- Whether a woman is before or after menopause.
ROMA helps doctors estimate the likelihood of ovarian malignancy in women with an ovarian or other adnexal mass who are being considered for surgery.
It does not provide a definitive diagnosis.
Why Are HE4 and CA-125 Used Together?
CA-125 may increase in ovarian cancer, but also in benign conditions such as endometriosis.
HE4 behaves differently in some of these conditions and may provide additional information.
Combining both markers can improve risk assessment in selected clinical situations.
However, blood test results must always be considered alongside ultrasound findings, symptoms, and medical history.
Can HE4 Be Elevated Without Cancer?
Yes. HE4 concentrations may increase for reasons unrelated to ovarian cancer.
These include reduced kidney function, increasing age, and smoking.
A result above the laboratory reference range therefore requires clinical interpretation.
Similarly, normal HE4 or CA-125 concentrations cannot reliably exclude ovarian cancer.
What Does a High ROMA Score Mean?
A high ROMA result indicates a higher-risk classification according to the algorithm.
It does not mean that a woman definitely has ovarian cancer.
A low-risk result also cannot completely exclude malignancy.
ROMA is intended to support specialist assessment and decisions about surgical care when an adnexal mass has already been identified.
How Do These Tests Fit Into Proactive Women’s Health Care?
Proactive medicine considers more than whether someone currently feels healthy.
Medical history, family history, symptoms, and previous examinations may reveal reasons for further investigation.
Ovarian cysts and other changes are frequently discovered during gynecological ultrasound examinations. Most are benign, but some require additional assessment.
In selected situations, CA-125 and HE4 may complement ultrasound and clinical evaluation.
ROMA has a narrower, specifically defined role in the preoperative assessment of women with an adnexal mass.
Neither HE4 nor ROMA is established as a routine ovarian cancer screening test for asymptomatic women at average risk.
The purpose of individualized preventive care is to select tests that provide meaningful information for a person’s particular circumstances, rather than relying on any single result.
