Colposcopic analysis of cervical lesions using popular scoring systems: Reid versus Swede

Objectives: To assess the effectiveness of colposcopy in detecting cervical lesions and to grade them according to Reid score and Swede score, and compare it with histopathology results.

Methods: This study was conducted on 130 patients in a tertiary care centre, who were subjected to pap smear and colposcopy. The cervical lesions were graded according to Reid score and Swede score, and a biopsy was obtained from the lesion. Histopathology results were correlated with colposcopy findings, and the scores were compared.

Results: The colposcopic findings using Reid score and Swede score correlated with histopathology results in the study population. The association between colposcopic impression and histopathology result was highly significant (p < 0.001), using both Reid score and Swede score. The sensitivity, specificity, PPV and NPV of Reid score (overall) was 86.2%, 80.20%, 55.56% and 95.3%, respectively. The diagnostic accuracy was 81.54%. At score > 5, specificity increased to 99% and diagnostic accuracy was 92.31%. The overall sensitivity, specificity, PPV, NPV and diagnostic accuracy of Swede score was 89.7%, 49.5%, 33.8%, 94.3% and 48.46%, respectively. As the cut off value increased, the sensitivity decreased. But the specificity, PPV, NPV and diagnostic accuracy increased and was statistically significant. The specificity and PPV was 100% at score > 8.

Conclusion: As the cut off value increased, the diagnostic accuracy of both the Scores increased, and was more accurate in detecting high-grade lesions.