Concierge gynae-oncology surveillance · London
Ovarian cancer screening (ROCA test), longitudinal CA-125 with algorithm-based risk for high-risk women.
The ROCA (Risk of Ovarian Cancer Algorithm) test combines serial CA-125 measurements with a proprietary algorithm to detect ovarian cancer earlier in high-risk women (BRCA1/2 carriers, Lynch syndrome, strong family history). Complements transvaginal ultrasound and MRI pelvis.
Why patients choose us
- 01
The right hands
We route you to a consultant gynae-oncologist or high-risk clinic — where ROCA is offered as part of a structured surveillance programme, not a one-off blood test.
- 02
Structured surveillance
ROCA is a 4-monthly programme with ultrasound triggers built in — we set the schedule up and keep it running.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Key facts
What the ROCA test is — in six lines.
The essentials, before the detail. Structured surveillance for defined high-risk cohorts, not a one-off blood test for the general population.
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Definition
Algorithmic serial CA-125 with a risk calculation for ovarian cancer.
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For high-risk women
Designed for BRCA1/2 carriers, Lynch syndrome, and strong family history.
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4-monthly blood tests
The algorithm needs longitudinal data, not a single snapshot.
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Ultrasound if elevated
Transvaginal ultrasound is added when the ROCA risk rises.
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UKCTOCS evidence
The UKCTOCS trial demonstrated modest stage-shift benefit in the multimodal arm.
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Not general-population
Not recommended for average-risk women — surveillance only in high-risk cohorts.
The problem
A single CA-125 doesn’t tell you much. A trajectory does.
ROCA reads the slope of your CA-125 over time. That is what makes it a surveillance programme rather than a screening test — and it is only as good as the schedule it runs on.
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BRCA1/2 carrier?
We set up a structured 4-monthly ROCA schedule with ultrasound triggers.
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Lynch syndrome?
We combine ovarian surveillance with the wider Lynch surveillance pathway.
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Strong family history?
We start with genetics and, where appropriate, enrol you into surveillance.
The pathway
From consultation to surveillance — what happens, in order.
Seven steps from the first high-risk consultation into a running 4-monthly programme.
- 01
Step 01
High-risk gynae-oncology consultation
A fertility or gynae-oncology consultant confirms surveillance is indicated.
- 02
Step 02
Genetic counselling
Formal counselling to review BRCA / Lynch status and family risk.
- 03
Step 03
Baseline CA-125 and pelvic ultrasound
A starting point for the algorithm and a structural baseline.
- 04
Step 04
4-monthly ROCA blood test
Serial CA-125 fed into the ROCA algorithm every four months.
- 05
Step 05
Ultrasound if ROCA elevated
Transvaginal ultrasound triggered when risk rises above threshold.
- 06
Step 06
Multi-disciplinary team review
Elevated or complex findings reviewed by the gynae-oncology MDT.
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Step 07
Consideration of risk-reducing surgery
Discussion of risk-reducing salpingo-oophorectomy where appropriate.
What it shows
When ROCA is the right test.
ROCA answers a specific question — how the trajectory of CA-125 in a high-risk woman compares to her own baseline, and what that means for the next step.
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Baseline CA-125
The starting value the algorithm builds every subsequent measurement against.
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Serial CA-125 trend
The trajectory over time — the algorithm reads the slope, not the single number.
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Elevated ROCA (increased risk)
A calculated risk score above threshold that triggers the next step.
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Complex ovarian mass on ultrasound
Solid or mixed cystic features on the triggered transvaginal scan.
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Post-oophorectomy monitoring
Surveillance after risk-reducing surgery where indicated.
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BRCA carrier surveillance
The core cohort ROCA was designed for — BRCA1 and BRCA2 pathogenic variants.
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Lynch syndrome surveillance
Screening in Lynch-associated ovarian and endometrial risk.
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Red flag: elevated ROCA + complex adnexal mass — urgent gynae-oncology MDT
This combination is an urgent MDT referral, not a routine follow-up.
Next steps
What follows a ROCA result.
What each option is actually for — from continuing surveillance to risk-reducing surgery.
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Continue surveillance if low ROCA
Stay on the 4-monthly schedule with no additional imaging.
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Increase surveillance frequency
Tighter interval testing when risk moves but does not cross threshold.
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Transvaginal ultrasound if elevated
The first-line imaging trigger from an elevated ROCA score.
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Diagnostic laparoscopy
Surgical assessment where imaging and biochemistry disagree.
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Risk-reducing salpingo-oophorectomy (BRCA)
The definitive risk-reduction option for BRCA carriers after family completion.
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Prophylactic hysterectomy (Lynch)
Considered in Lynch syndrome for combined ovarian and endometrial risk.
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Genetic counselling and cascade testing
Family cascade testing to identify other carriers who benefit from surveillance.
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Multi-disciplinary team review
All abnormal results and surgical decisions taken through the gynae-oncology MDT.
Red flags
Features that shift the pathway.
Any of these on their own or in combination move the case out of routine surveillance and into the gynae-oncology MDT.
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BRCA1/2 pathogenic variant
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Lynch syndrome
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Family history of ovarian cancer
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Elevated ROCA
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Complex ovarian mass with ascites
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Post-menopausal bleeding
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Unexplained weight loss
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Persistent bloating
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Peritoneal carcinomatosis features
Safety and eligibility
A blood test — but a programme, not a one-off.
ROCA itself carries the risks of a venous blood draw. The practical points are who it is for, how the cadence works, and what a normal result does and doesn’t rule out.
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A blood test, not a scan
ROCA itself is a venous blood draw — no radiation, no preparation, no recovery.
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Longitudinal, not one-off
A single CA-125 is not ROCA. The algorithm needs at least a baseline plus one interval reading.
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4-monthly cadence
Missing intervals blunts the algorithm — the schedule matters as much as the test itself.
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Not for general-population screening
Evidence supports use in defined high-risk cohorts, not average-risk women.
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Ultrasound is the trigger
Transvaginal ultrasound is added when ROCA rises — not as a routine paired test at every visit.
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Genetic counselling first
Enrolment usually follows a formal genetics discussion, not a self-referred blood test.
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A normal ROCA is not a full clear
ROCA reduces stage at diagnosis in the evidence — it does not eliminate risk.
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Risk-reducing surgery is the standard for BRCA
For BRCA carriers after family completion, surgery reduces ovarian cancer risk more than surveillance alone.
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Bring prior CA-125 and imaging
Comparison against previous values is what the algorithm runs on — bring what you have.
Reading your report
A ROCA report is short. The score is the answer.
Whatever the finding, the report keeps to the same four parts.
A quiet reminder
The report is written for your doctor, not for you — and that’s normal.
If you would like us to talk you through it before your follow-up, just ask.
- 01 Header
Indication and risk category
Your details, the reason for surveillance, and the risk group that shapes interpretation.
- 02 Technique
CA-125 assay and interval
Which assay was used, the interval since the last reading, and the algorithm version.
- 03 Findings
CA-125 value and ROCA score
The absolute value, the algorithm-derived risk, and any ultrasound trigger status.
- 04 Impression
The conclusion: read this first
Continue routine surveillance, tighter interval, or ultrasound / MDT trigger — read this first.
Recognised by major UK insurers
Cover depends on your policy and clinic; we confirm with your insurer before booking.
Frequently asked
Everything we get asked about the ROCA test.
Quick answers on who it’s for, how often, what triggers ultrasound, and where risk-reducing surgery fits.
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What is the ROCA test?
ROCA — Risk of Ovarian Cancer Algorithm — combines your serial CA-125 measurements with a proprietary algorithm to estimate ovarian cancer risk in high-risk women. It is not a single blood test but a longitudinal surveillance programme.
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Who is ROCA for?
ROCA is designed for high-risk women: BRCA1/2 carriers, Lynch syndrome, and those with a strong family history of ovarian cancer. It is not recommended as general-population screening.
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How often is the ROCA test done?
Every four months. The algorithm reads the trajectory of CA-125 over time, so intervals matter — missing tests blunts the algorithm’s sensitivity.
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What happens if my ROCA is elevated?
An elevated ROCA triggers a transvaginal ultrasound. Depending on the findings, the next step is either tighter surveillance, gynae-oncology MDT review, or diagnostic laparoscopy.
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Does ROCA replace risk-reducing surgery?
No. For BRCA carriers who have completed their family, risk-reducing salpingo-oophorectomy remains the most effective way to reduce ovarian cancer risk. ROCA is surveillance for women not yet at that point.
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How quickly will I get results?
CA-125 typically returns within a few days; the ROCA score is calculated and reported once the value is fed into the algorithm, usually within a week of the blood draw.
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In practice, in London
Booking ovarian cancer screening roca test privately in London — what actually happens
With ovarian cancer screening roca test, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. Public provision for ovarian cancer screening roca test is competent but constrained by capacity. Private London clinics tend to have shorter diaries and longer appointment slots, so you get the same specialists with more time. For people who’ve been going round in circles with primary care, that first proper conversation is often what shifts things.
Once you’re in the private system for ovarian cancer screening roca test, the pace picks up noticeably. Consultant slots run to time, imaging is usually available in the same building or a short walk away, and the report comes back typed and detailed. It’s the coordination that tends to feel different — one person on the other end of the phone, not a switchboard. For ovarian cancer screening roca test specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
Honesty about expectations is part of the job. A private ovarian cancer screening roca test appointment in London won’t change the underlying medicine — the guidelines, the consultants, and the equipment are largely the same as on the NHS. What it changes is speed, continuity, and the amount of time you get to actually talk through the findings. Everyone we route to is GMC-registered and works within CQC-regulated facilities.