Predictive Value of Swede Colposcopy Score for Predicting Cervical Intra Epithelial Neoplasia in Cervical Cancer Screening with Visual Inspection with Acetic Acid

Abstract

Objectives: To assess the predictive value of Swede score with VIA as the screening method and identify a cut-off score that predicts high grade CIN.
Methods: Records of 324 women who were VIA positive and had acetowhite lesion on colposcopy graded according to Swede score followed by biopsy/excisional procedure were included in the analysis. Sensitivity, Specificity, PPV & NPV for each Swede score were calculated and area under the ROC curve (AUROC) for score predicting high grade histopathology (≥ CIN 2) was estimated. A p value less than 0.05 was considered statistically significant.
Results: As the swede score increased from 0 to 10, the sensitivity decreased and specificity increased i.e. sensitivity of score < 6 was high whereas specificity of score > 6 was high. At a cut-off of Swede Score ≥6, it predicted high grade histology with a sensitivity of 51%, and a speci-ficity of 79%. The highest diagnostic accuracy was at swede score cut off >6 i.e. 64.6%.
Conclusion: We recommend biopsy at a Swede score of 5 or less and treatment by excision at a Swede score of 6 or more.