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Abstract
Introduction: Cervical cancer is the second most common malignancy among women in India. The pap smear being the most commonly used screening tool has low sensitivity. Colposcopy determines the location, size and extent of abnormal cervical lesions. Guided biopsy can be taken. The Colposcopic scoring systems are Reid’s colposcopic index (RCI) and Swede score with later also incorporating the lesion size as a variable.
Aims and objectives: To assess the comparative efficacy of RCI and Swede score as a screening tool for cervical cancer with histopathology as a gold standard.
Methodology: Women with abnormal screening result were enrolled and subjected to colposcopy. RCI and Swede score was calculated. Biopsy taken from abnormal areas. Performances of both the scores were calculated.
Result: For prediction of cervical lesions, RCI Score at a cutoff score of ≥3 has a sensitivity of 80%, specificity-66%, Positive predictive value (PPV)-66%, Negative predictive value (NPV)-80% and Diagnostic accuracy (DA)-73% while Swede Score at a cutoff of ≥4 has a sensitivity of 88%, specificity-63%, PPV-66%, NPV-86% and DA-74%.
Conclusion: Swede score had better sensitivity and a better NPV for higher grade lesions. It has better histopathological correlation allowing us to directly approach for ‘SEE AND TREAT PROTOCOL’ if the score is ≥8 in countries like India which has limited resources for histopathology.
