Differentiation between benign and malignant ovarian neoplasms is essential for creating a system for patient referrals. Therefore, the contributions of the tumor markers CA125 and human epididymis protein 4 (HE4) as well as the risk ovarian malignancy algorithm (ROMA) and risk malignancy index (RMI) values were considered individually and in combination to evaluate their utility for establishing this type of patient referral system.Ovarian cancer is the seventh most common cancer in women and is not diagnosed before reaching an advanced stage in approximately 70% of all cases. As a consequence, the 5-year survival rate associated with ovarian cancer is less than 30% . Therefore, both surgical staging and the performance of optimal cytoreduction procedures in reference centers may have a substantial impact on patient survival.