A 2014 meta-analysis comparing the diagnostic accuracy of ROMA® with single marker HE4 and CA125 found that ROMA® aligned more with CA125 and was more suitable for diagnosing postmenopausal ovarian carcinomas, whereas the additional specificity afforded by the inclusion of HE4 made it better at identifying premenopausal malignancies [177]. This evidence concerns the gene WFDC2 and ovarian carcinoma.