Comparative study of Diagnostic Accuracy of Reid’s Index and Swede Score with Cervical Histopathology in early detection of premalignant and malignant cervical lesions

Authors: Hemraj Narkhede, Rahul Bhagchand Chavan, Varsha Sinha, Nutan Wanjare

DOI: 10.18231/j.ijogr.10036.1762249125

Keywords: Cervical Cancer, Colposcopy, Swede Score, Reid's Colposcopic Index, Histopathol

Abstract: Introduction: Cervical cancer is a significant concern in India and other developing countries, with high mortality rates due to late-stage diagnosis. Effective screening programs have reduced cervical cancer rates in developed countries, but limited access to screening in low-resource settings contributes to high incidence. This study compares Reid's Colposcopic Index and the SWEDE score to improve colposcopy's accuracy in diagnosing cervical cancer and precursor lesions, offering potential benefits for early detection in resource-limited regions. The goal of this study was to enhance the early detection of premalignant and malignant cervical lesions using colposcopy as a diagnostic tool. Methods: This observational study was conducted at tertiary care hospital, India, over a 12-month period. The study comprised 70 women aged 30 to 59 years, attending the gynaecology outpatient department, who met the inclusion and exclusion criteria include in study smear and Colposcopy were performed for all. Colposcopy graded according to Reid’s or Swedes index. Results: In this 12-month observational study of 70 women aged 30-59, colposcopy performance was evaluated. Swede score had better sensitivity (50.00%) and specificity (96.00%) at a cut-off of 8, while Reid's Colposcopic Index (RCI) had 95.23% sensitivity and 51.02% specificity at a cut-off of 3 for detecting CIN 2 or worse. Swede score outperformed RCI when considering lesion size as an additional criterion. An excellent correlation (R² = 0.947) was observed between RCI and Swede score. Punch biopsy was cervix for histopathology was taken for all irrespective of score. Diagnostic Accuracy of Reid’s Index and Swede Score with Cervical Histopathology in early detection of premalignant and malignant cervical lesions were studied. Conclusion: Swede Score, with lesion size as an extra criterion, outperforms Reid's Colposcopic Index. The lower threshold of 5 is suitable for screening, and the higher threshold of 8 is effective for screen-and-treat, reducing clinic visits, especially in resource-limited settings like India.