Citation Information :
Agarwal N, Gupta M, Agrawal A. Colposcopic Evaluation Using Swede Score as a Tool to Screen Suspicious-looking Cervix and its Correlation to Histopathological Findings. J South Asian Feder Obs Gynae 2023; 15 (2):178-182.
Background: Cancer cervix is one of the leading causes of female mortality in India. Different methods are used for its screening as it has a long latent phase. Colposcopic-directed cervical biopsy of an unhealthy-looking cervix is taken as the gold standard in the diagnosis of cervical intraepithelial lesions. However, a relatively new colposcopy scoring system known as the Swede score has a high specificity and can omit the need of biopsy in preinvasive cervical lesions.
Objective: To evaluate the efficacy of colposcopy using Swede score as a screening modality in unhealthy cervix and to correlate its finding with histopathology.
Materials and methods: The present study has been conducted in the Department of Obstetrics & Gynaecology at a tertiary care facility of North India from 1st June 2020 to 31st May 2021. Among 99 patients who fulfilled the inclusion and exclusion criteria, colposcopy was done, and cervical biopsy was taken from the suspicious sites. The findings of colposcopy and histopathology were correlated.
Result: About 23% (23/99) of the total patients had a Swede score of 5 or more, out of whom 43.47% (10/23) were found to have preinvasive or invasive lesions (p-value < 0.001).
Using a Swede score >8, 80% (8/10) patients had preinvasive or invasive lesions with a significant p-value of <0.001. Swede score of 8 or above had an excellent specificity of 100% for high-grade lesions, although the sensitivity was 80%. However, on lowering the cutoff to 5, the sensitivity improved to 100% at the cost of specificity (85.23%).
Conclusion and clinical significance: It was evident that colposcopy, using Swede score of >5 and even of >8 as cutoff, is definitely more sensitive and accurate in screening of unhealthy-looking suspicious cervix in Indian population and can be considered to use for treating the patients directly by excision or cryotherapy as a “see and treat” method, avoiding the need for cervical biopsy for histopathological confirmation.
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