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Mayo Clinic Laboratories > Women’s health > Adnexal masses

Adnexal masses

Noninvasive testing for ovarian cancer

Physicians treating women who have adnexal masses need clear insights into their patients’ condition to help guide their course of action. A suite of tests is available to help clinicians assess the risk of ovarian cancer for women who have adnexal masses. Results provide a risk assessment to support clinical decision-making, including appropriate monitoring, referral, and surgical planning.

18%–31%

18%–31% of adnexal masses are classified as indeterminate after clinical assessment1

6 of 7

6 of 7 women are found to have benign tumors after surgery2

Adnexal masses test menu 

Adnexal masses Adnexal masses

Adnexal masses

Mayo Clinic Laboratories offers a range of testing that can help clinicians stratify risk and guide management for women who have adnexal masses.

Key testing

  • OVAPA | Ovarian Malignancy Risk Assessment, Ova1Plus, Serum
    • Ova1Plus® is a combination of two U.S. Food and Drug Administration (FDA)-cleared blood tests to detect the risk of ovarian malignancy in women with adnexal masses planned for surgery.
    • The proprietary reflex process combines two FDA-cleared tests: Ova1®, leveraging high sensitivity, and Overa®, leveraging high specificity, for patients with adnexal masses.
    • When surgery is indicated for an adnexal mass, Ova1Plus helps stratify malignancy risk and informs whether involvement of a gynecologic oncologist should be considered.
    • With clinical assessment, Ova1 offers 96%1 sensitivity and 98%1 negative predictive value to equip providers with the comprehensive ovarian cancer risk intelligence needed to optimize surgical management plans.
  • OVAWA | Ovarian Mass Risk Monitoring, OvaWatch, Serum
    • The only clinical assay available to assess the risk of ovarian cancer for women with adnexal masses evaluated by initial clinical assessment as indeterminate or benign.
    • With a negative predictive value over 99%2, a lower OvaWatch® score indicates a very low probability of malignancy for confidence and peace of mind.
    • The longitudinal monitoring feature of OvaWatch® provides an individualized ovarian cancer risk assessment over time, enabling a dynamic and comprehensive view of a patient’s risk profile.
    • A clinical report provides test results that refine and reduce the number of masses classified as indeterminate and, in conjunction with imaging (ultrasound and/or CT) and clinical assessment, can help providers determine next steps.
    • If OvaWatch returns an indeterminate result, this means the test could not confidently rule out malignancy. However, an indeterminate result is not equal to the presence of malignancy and indicates further testing is warranted.
  • ROMA | ROMA Score (Ovarian Malignancy Risk Algorithm), Serum
    • In conjunction with clinical and radiological assessment, assigns women who present with an adnexal mass into a high-risk or low-risk group for finding an ovarian malignancy.
    • Incorporates cancer antigen 125 (CA125), human epididymal protein 4 (HE4), and menopausal status.
    • Indicated for women who are older than age 18, presenting with an adnexal mass for which surgery is planned, and who have not yet been referred to an oncologist.
    • Not intended as a screening or stand-alone diagnostic assay for ovarian cancer.
References
  1. Bristow RE, Smith A, Zhang Z, et al. Ovarian malignancy risk stratification of the adnexal mass using a multivariate index assay. Gynecol Oncol. 2013;128(2), 252-259.
  2. Reilly G, Bullock RG, Greenwood J, et al. Analytical validation of a deep neural network algorithm for the detection of ovarian cancer. JCO Clin Cancer Inform. 2022;6:e2100192. doi:10.1200/CCI.21.00192