Comparative Analysis between Reid’s Colposcopic Index and Swede’s Score for Detection of Premalignant Lesions of Cervix: A Prospective Study

Abstract

Introduction: Colposcopy is an effective tool to detect premalignant lesions of the cervix. It is an observer-dependent technique; hence, various colposcopic-based scoring systems have been employed to minimise interobserver variations. Aim: To compare Reid’s Colposcopic Index (RCI) and Swede’s score for the detection of premalignant lesions of the cervix and compare it with colposcopic directed biopsy and histopathology. Materials and Methods: In this prospective observational study conducted at a tertiary care hospital in Delhi, India, between August 2019 to April 2020, 100 women of the reproductive age group were recruited. Pap (Papanicolaou) smear and colposcopy were done for all the patients. Scoring of colposcopic lesions was done according to Reid’s and Swede’s scoring system. In women with RCI or Swedes score ≥3, biopsy of the cervix for histopathology was carried out. Data was recorded and statistically analysed using Statistical Package for the Social Sciences (SPSS) software. Pearson and spearmen correlation coefficient was used for correlation of RCI and Swede’s score. Results: Mean age of women was 43.89±8.2 years. A positive correlation was found between RCI and Swedes score as the correlation coefficient was 0.995 and p-value<0.001. Sensitivity was better with Swede’s scoring system as compared to RCI for predicting Cervical Intraepithelial Neoplasia (CIN)-I lesions. However, for predicting CIN-II and CIN-III lesions sensitivity with both the scoring system was comparable. The sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of RCI at a cut-off score of 5 was 54.54%, 87.17%, 54.54%, and 87.1% for CIN-I, for CIN-II was 100%, 86.67%, 45.45%, and 100%. CIN-III was 100%, 82.1%, 22.7%, and 100%. Similarly, the sensitivity, specificity, PPV, and NPV of Swedes score at a cut-off score of 5 was 59%, 84.6%, 52%, and 88% for CIN-I, for CIN-II was 100%, 83.33%, 40%, and 100%. And that for CIN-III was 100%, 78.94%, 20% and 100%. Conclusion: Both scoring systems performed well in predicting CIN lesions.

Keywords

• cervical biopsy
• colposcopy
• premalignant cervical lesion
• reid’s colposcopic index
• swede’s score