Colposcopic Evaluation of Cervical Lesions with Swede Score and its Correlation with Histopathology

Abstract

Background & Objectives: Cervical cancer is the second most frequent cancer in India, with an estimated yearly diagnosis of 1, 23,907 women and 77,348 fatalities. The prevalence of cervical cancer remains high in poorer nations owing to budget constraints and a lack of access to healthcare. By evaluating cervical lesions colposcopically, this study sought to determine the validity of the Swede score. Methods: The cross-sectional analytical study lasted two years, from July 2019 to July 2021, at Krishna Institute of Medical Sciences, Karad. 162 women who met the selection criteria underwent colposcopy after informed consent. The suspicious site was biopsied and submitted for histopathology. The Swede score was subsequently validated using histopathology. Results: With a Swede score of 5 as the cut-off, 108 (97.30 %) of 111 patients with a score of <5 had a normal or low-grade lesion, while just 3 (2.70 %) had high grade lesion. 51 patients with a score greater than 5, 15 (12.20%) had a low-grade lesion and 36 (92.30%) had high-grade lesion. Using the Swede score of 8 as a cut-off, 123 (87.90%) of 140 patients had a normal or low-grade lesion, whereas 17 (12.1%) had a high-grade lesion. There were high grade lesions in all 22 patients with score of >8. Interpretation & Conclusions: The test group at Swede score cut-off 5 exhibited a sensitivity of 92.31 % and a specificity of 87.80 % to the gold standard of histopathology. Comparing the test group's Swede score at cut-off 8 to histopathology yielded a sensitivity of 56.41% and specificity of 100%.