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Ovarian cancer is the 5th most common cause of cancer death in women. Human Epididymal protein 4 (HE4) is an highly sensitive single tumour marker produced by most, but not all epithelial ovarian cancer cells. Risk of Ovarian Malignancy Algorithm (ROMA) is a numerical score that can be used to detect ovarian cancer. This test is important for early detection of ovarian cancer, accurate monitoring of ovarian cancer after treatment, and detection of a recurrence or progression of ovarian cancer.