DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20222295
Published: 2022-08-29

Efficacy of the Swede score in prediction of high-grade lesions of cervix

Lipika Chowdhury, Shahanara Chowdhury, Nasreen Banu, Zenifar Sharmin, Masuma Tabassum, Marjan Sultana, S. K. Tasnuva Alam

Abstract


Background: Cervical cancer is a preventable lesion that can be identified by stepwise screening methods. Visual inspection of the cervix with acetic acid, Lugol’s iodine, pap smear, and HPV are the primary screening methods. This study aims to evaluate the efficacy of the Swede score in predicting high-grade lesions of the cervix among patients attending a colposcopy clinic. 

Methods: This observational cross-sectional study was performed in a colposcopy clinic under the department of obstetrics and gynaecology at CMCH. All referral patients to the colposcopy clinic were the study population. Women aged between 25-65 years was the study subject. 

Results: Majority (47.5%) of the patient’s Swede score was 4 and 20.1of % of patients had scores of 5-6 and only 1.3% of patients had scores ≥7%. 63 (79%) patients had low grade/normal/ cervical intraepithelial lesion (CIN) 1, 16 (20%) patients had high grade/non-invasive cancer/CIN 2 and only 1 patient had high grade/suspected invasive cancer/CIN 3. A score of 6 had a specificity of 100% for CIN 2 with a sensitivity of 30% positive and negative predictive value (PPV=100%; NPV=90.9%). Lowering the score to 5 for predicting CIN 2 improved the sensitivity at the expense of specificity (sensitivity=60%; specificity=90%; PPV= 94%; NPV=46.2%).

Conclusions: Swede scoring system is consistent and reproducible, has a simple structure, and thus contributes to preventing cervical cancer. Swede score of 6 or more has 100% specificity; this scoring method is a preferred method for the treatment of high-grade CIN. 


Keywords


Swede score, High-grade lesions, Efficacy, Prediction

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References


Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359-86.

Farlay D, Panczer G, Rey C, Delmas PD, Boivin G. Mineral maturity and crystallinity index are distinct characteristics of bone mineral. J Bone Mineral Metabol. 2010;28(4):433-45.

Bejnordi BE, Veta M, Van Diest PJ, Van Ginneken B, Karssemeijer N, Litjens G et al. Diagnostic assessment of deep learning algorithms for detection of lymph node metastases in women with breast cancer. JAMA. 2017;318(22):2199-210.

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. Cancer J Clinicians. 2018;68(6):394-424.

Penumalli S, Kasthuri TB. Evaluation of colposcopy using Swede score in screening of cervical cancer. J Evolution Med Dental Sci. 2017;6(94):6868-72.

Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JW, Comber H et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Euro J Cancer. 2013;49(6):1374-403.

Bobdey S, Sathwara J, Jain A, Balasubramaniam G. Burden of cervical cancer and role of screening in India. Indian J Med Paediatr Oncol. 2016;37(04):278-85.

Luo Y, Ferdous Z, Leslie WD. Precision study of DXA‐based patient‐specific finite element modeling for assessing hip fracture risk. International journal for numerical methods in biomedical engineering. 2013;29(5):615-29.

Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JW, Comber H et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Euro J Cancer. 2013;49(6):1374-403.

Ubayasiri K. Framing statelessness and'belonging': Rohingya refugees in Bangladesh's the Daily Star newspaper. Pacific Journalism Rev. 2019;25(1/2):260-76.

Šarenac T, Mikov M. Cervical cancer, different treatments and importance of bile acids as therapeutic agents in this disease. Frontiers in Pharmacol. 2019;10:484.

Mishra SP, Thirree J, Manent AS, Chabot B, Daneault C. Ultrasound-catalyzed TEMPO-mediated oxidation of native cellulose for the production of nanocellulose: effect of process variables. BioResources. 2011;6(1):121-43.

Ajenifuja KO, Gage JC, Adepiti AC, Wentzensen N, Eklund C, Reilly M et al. A population-based study of visual inspection with acetic acid (VIA) for cervical screening in rural Nigeria. Int J Gynecol Cancer. 2013;23(3).

Nessa A, Wistrand C, Begum SA, Thuresson M, Shemer I, Thorsell M et al. Evaluation of stationary colposcope and the Gynocular, by the Swede score systematic colposcopic system in VIA positive women: a crossover randomized trial. Int J Gynecol Cancer. 2014;24(2).

Nessa A, Wistrand C, Begum SA, Thuresson M, Shemer I, Thorsell M et al. Evaluation of stationary colposcope and the Gynocular, by the Swede score systematic colposcopic system in VIA positive women: a crossover randomized trial. Int J Gynecol Cancer. 2014;24(2).

Arbyn M, Kyrgiou M, Simoens C, Raifu AO, Koliopoulos G, Martin-Hirsch P et al. Perinatal mortality and other severe adverse pregnancy outcomes associated with treatment of cervical intraepithelial neoplasia: meta-analysis. BMJ. 2008;337.

Purcell SM, Moran JL, Fromer M, Ruderfer D, Solovieff N, Roussos P, O’dushlaine C, Chambert K, Bergen SE, Kähler A, Duncan L. A polygenic burden of rare disruptive mutations in schizophrenia. Nature. 2014;506(7487):185-90.

Gage JC, Hanson VW, Abbey K, Dippery S, Gardner S, Kubota J et al. Number of cervical biopsies and sensitivity of colposcopy. Obstetr Gynecol. 2006;108(2):264-72.

Stranger BE, Forrest MS, Clark AG, Minichiello MJ, Deutsch S, Lyle R et al. Genome-wide associations of gene expression variation in humans. PLoS genetics. 2005;1(6):e78.

Reid R, Scalzi P. Genital warts and cervical cancer: VII. An improved colposcopic index for differentiating benign papillomaviral infections from high-grade cervical intraepithelial neoplasia. Am J Obstetr Gynecol. 1985;153(6):611-8.

Ferris DG, Litaker MS, ALTS Group. Prediction of cervical histologic results using an abbreviated Reid Colposcopic Index during ALTS. Am J Obstetr Gynecol. 2006;194(3):704-10.

Ständer S, Schmelz M, Metze D, Luger T, Rukwied R. Distribution of cannabinoid receptor 1 (CB1) and 2 (CB2) on sensory nerve fibers and adnexal structures in human skin. Journal of dermatological science. 2005;38(3):177-88.

Swami D, Parthasarathy D. Dynamics of exposure, sensitivity, adaptive capacity and agricultural vulnerability at district scale for Maharashtra, India. Ecological Indicators. 2021;121:107206.

Maloof AC, Porter SM, Moore JL, Dudás FÖ, Bowring SA, Higgins JA et al. The earliest Cambrian record of animals and ocean geochemical change. Bulletin. 2010;122(11-12):1731-74.

Das SK, Debasish D, Saranya N, Snigdha P, Rabindranath G, Abhijit D. Revisiting the physiology of ascent of sap in plants: legendary experiment of JC Bose. Current Sci. 2018;115(8):1451-3.

Toigo V, Piovan R, Dal Bello S, Gaio E, Luchetta A, Pasqualotto R et al. The PRIMA Test Facility: SPIDER and MITICA test-beds for ITER neutral beam injectors. New J Physics. 2017;19(8):085004.

Alim SA, Kibria SM, Uddin MZ, Nessa M, Wahab MA. Translation of DASS 21 into Bangla and validation among medical students. Bangl J Psychiatry. 2014;28(2):67-70.

Penumalli S, Kasthuri TB. Evaluation of colposcopy using Swede score in screening of cervical cancer. J Evolution Med Dental Sci. 2017;6(94):6868-72.

Shakuntala PN, Ashmita D, Shubha RR, Usha R. Reproductive Wastage in Recurrent Partial Hydatidiform Mole: A Clinical Dilemma. Online J Health Allied Sci. 2013;11(4):14.

Stranger BE, Forrest MS, Clark AG, Minichiello MJ, Deutsch S, Lyle R et al. Genome-wide associations of gene expression variation in humans. PLoS genetics. 2005;1(6):e78.

Whitney N, Pearson LJ, Lunsford R, McGill L, Gomer RH, Lindsey DF. A putative Ariadne-like ubiquitin ligase is required for Dictyostelium discoideum development. Eukaryotic Cell. 2006;5(10):1820-5.

Hur S, Lim H, Lyu J. “I” or “she/he”? The effects of visual perspective on consumers’ evaluation of brands’ social media marketing: From imagery fluency perspective. J Global Fashion Marketing. 2020;11(1):1-7.

Maloof AC, Porter SM, Moore JL, Dudás FÖ, Bowring SA, Higgins JA et al. The earliest Cambrian record of animals and ocean geochemical change. Bulletin. 2010;122(11-12):1731-74.

Caielli S, Veiga DT, Balasubramanian P, Athale S, Domic B, Murat E et al. A CD4+ T cell population expanded in lupus blood provides B cell help through interleukin-10 and succinate. Nature Med. 2019;25(1):75-81.