HE4 with ROMA Index Test: Booking, Price, and Results
About HE4 with ROMA Index Test: Booking, Price, and Results
| Field | Value |
|---|---|
| Also Known As | Risk of Ovarian Malignancy Algorithm (ROMA) Test |
| Sample Type | Venous blood (serum) |
| Fasting Required | No fasting required |
| Report Time | 48 to 72 hours |
| Recommended For | Women above 18 years with a pelvic or adnexal mass |
| Price | Starting at ₹4,000 |
What Is an HE4 with ROMA Index Test?
The HE4 with ROMA index test is a blood test that measures two proteins, HE4 (human epididymis protein 4) and CA-125 (cancer antigen 125), and combines them with a woman's menopausal status to calculate a risk score for ovarian cancer. Doctors order it when a woman has a pelvic or adnexal mass (a growth near the ovaries or fallopian tubes) and surgery is being considered. The test helps classify the mass as either high-risk or low-risk for malignancy before any procedure takes place. It is also known as the risk of ovarian malignancy algorithm (ROMA) test.
What Does an HE4 with ROMA Index Test Measure?
This test analyses three components, each contributing to the final risk calculation. Here is what each one measures:
| Component | What It Is | Why It Matters |
|---|---|---|
| HE4 (Human Epididymis Protein 4) | A protein produced by ovarian and respiratory tract cells | Often elevated in epithelial ovarian cancer; more specific than CA-125 alone |
| CA-125 (Cancer Antigen 125) | A tumour marker protein found in blood | Can be raised in ovarian cancer and several non-cancerous conditions |
| ROMA Index | A calculated score combining HE4, CA-125, and menopausal status | Classifies a woman with a pelvic mass as high-risk or low-risk for ovarian cancer |
Why Is an HE4 with ROMA Index Test Done?
A doctor may order this test when a woman presents with a pelvic or adnexal mass and a clinical decision about surgery is being considered.
Common Symptoms That May Require This Test
Women experiencing any of the following symptoms alongside a known pelvic mass may be referred for the HE4 with ROMA index test:
- Pelvic or abdominal pain that persists
- Noticeable increase in abdominal size or bloating
- Urinary urgency or increased frequency
- Feeling full very quickly when eating
- Difficulty eating normal-sized meals
- Unexplained weight loss
Conditions This Test Can Help Detect
Doctors use the risk of ovarian malignancy algorithm (ROMA) test to evaluate or monitor the following conditions:
- Likelihood of malignancy in a known pelvic or adnexal mass before surgery
- Epithelial ovarian cancer (the most common type, which starts in the cells lining the ovaries)
- Recurrence or progression of ovarian cancer in women already treated for the condition
HE4 with ROMA Index Test for Chronic Disease Monitoring
For women previously treated for epithelial ovarian cancer, this test plays a useful role in follow-up care. Serial testing of HE4, CA-125, and the ROMA score can help track how the disease is responding to treatment and signal early signs of recurrence. Doctors use it as part of an ongoing monitoring plan alongside imaging and clinical review.
How to Prepare and What to Expect
No special preparation is needed for this test, but a few simple steps will help ensure accurate results.
Do You Need to Fast?
No, fasting is not required before the HE4 with ROMA index test. You can eat and drink normally before your appointment. Always follow the instructions given by your doctor or the diagnostic centre at the time of booking.
Practical Tips Before Your Test
A few simple steps can help ensure your sample gives the most accurate result possible:
- Stop taking biotin (vitamin B7) supplements at least 72 hours before the test, as biotin can interfere with the result
- Note and share the date of your last menstrual period or confirm your menopausal status when giving the sample, as this is needed to calculate the ROMA score
- Tell your doctor about any current medications, hormonal therapy, or kidney disease, as these can affect how results are interpreted
- Let your doctor or the collection team know if you smoke, as smoking can raise HE4 levels
Step-by-Step Procedure
The sample collection process is straightforward and takes only a few minutes:
- A trained phlebotomist will clean the skin on your inner arm with an antiseptic wipe.
- An elastic band is placed around your upper arm to make the veins easier to see.
- A small needle is inserted into a vein, and a blood sample is drawn into collection tubes.
- The needle is removed, and a small bandage is placed over the site.
- The blood sample is prepared for serum separation and labelled carefully.
- The sample is sent to the laboratory for analysis.
Factors That Can Affect Accuracy
Certain factors may influence your HE4 with ROMA index test results and should be discussed with your doctor:
- Menopausal status and age (HE4 levels differ between premenopausal and postmenopausal women)
- Smoking status (smokers may have higher HE4 levels)
- Chronic kidney disease (can raise HE4 without any cancer being present)
- Biotin supplementation taken close to the test date
- The specific testing method used, as results from different platforms cannot be compared directly
Understanding Your HE4 with ROMA Index Test Results
Your results will show individual values for HE4 and CA-125, along with a calculated ROMA score. Always review these with your doctor, who will consider your full clinical picture before drawing any conclusions.
| Parameter | Reference Range | Unit |
|---|---|---|
| HE4 (premenopausal) | Less than 70 to 89 | pmol/L |
| HE4 (postmenopausal) | Less than 128 | pmol/L |
| CA-125 | Less than 35 | U/mL |
| ROMA Index (premenopausal) | 1.14 or greater (high risk)Less than 1.14 (low risk) | % |
| ROMA Index (postmenopausal) | 2.99 or greater (high risk)Less than 2.99 (low risk) | % |
These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
Certain health conditions can affect how results should be read:
- Chronic kidney disease may raise HE4 levels even when no cancer is present. Results should be interpreted carefully in women with known kidney problems.
- Smoking is associated with higher HE4 serum levels, which may affect interpretation. Your doctor should be aware of your smoking status.
- Menopausal status and age significantly influence HE4 values. Premenopausal and postmenopausal women have different reference ranges, so accurate status reporting is important.
- Conditions such as endometriosis, uterine fibroids, menstruation, and pelvic inflammatory disease can raise CA-125 levels, which may in turn affect the ROMA calculation.
How to Maintain Healthy Levels
These general wellness habits support overall gynaecological health:
- Attend regular gynaecological check-ups, especially if you have a family history of ovarian or breast cancer
- Report any persistent pelvic symptoms, bloating, or urinary changes to your doctor without delay
- If you have kidney disease, make sure your treating doctor is aware before this test is ordered, as it is relevant to how your results will be read
Lupin Diagnostics HE4 with ROMA Index Test Price and Home Collection
The HE4 with ROMA index test price at Lupin Diagnostics starts at ₹4,000, and home sample collection is available across cities in India. The table below shows approximate prices at major locations:
| City | Approximate Price (₹) |
|---|---|
| Mumbai | ₹4000 |
| Bengaluru | ₹4000 |
| Hyderabad | ₹4000 |
| Chennai | ₹4000 |
| Kolkata | ₹4000 |
| Pune | ₹4000 |
Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
Follow these steps to book your test:
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred time slot.
- Opt for home sample collection by a certified phlebotomist, or visit your nearest Lupin Diagnostics centre.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Home Collection
Lupin Diagnostics offers home sample collection for the HE4 with ROMA index test across major Indian cities. All samples are processed in NABL-accredited laboratories by experienced technologists. Your digital report is delivered directly to your email or WhatsApp, making the process easy and convenient.
Frequently Asked Questions
The ROMA index is a calculated score that combines HE4, CA-125, and a woman's menopausal status to estimate the likelihood that a pelvic mass is malignant. It helps doctors decide whether to refer a patient to a gynaecological oncologist before surgery. It is a decision-support tool, not a standalone diagnosis.
No. The risk of ovarian malignancy algorithm (ROMA) test is intended for women who already have a known adnexal mass and are being evaluated for surgery. It is not validated as a general cancer screening tool and should not be used as such.
Yes, it can. HE4 levels may be elevated in women with chronic kidney disease even when no ovarian cancer is present. If you have kidney disease, tell your doctor before the test so they can factor this into their interpretation.
No. HE4 is not appropriate for monitoring mucinous or germ cell ovarian cancers, as these types rarely produce HE4 protein. Your doctor will advise whether this test is the right monitoring tool for your specific diagnosis.
You do not need to fast, but you should stop taking biotin (vitamin B7) supplements at least 72 hours before sample collection. Biotin can interfere with the assay and potentially affect your results.
No fasting is needed. You can eat and drink as normal before your sample is collected. However, you should stop any biotin (vitamin B7) supplements at least 72 hours before the test to avoid interference with the results.
No. The ROMA index has not been validated for use in pregnant women, and the test is not recommended for women currently undergoing chemotherapy or those previously treated for malignancy. If you are pregnant, speak to your doctor about alternative options.
HE4 with ROMA Index Test: Booking, Price, and Results
