EVALUATION OF COLPOSCOPY USING SWEDE SCORE IN SCREENING OF CERVICAL CANCER
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 94
Abstract
BACKGROUND Cervical cancer is a global health problem. It ranks as the 4th leading cause of female cancer in the World,(1) the 2nd leading cause of female cancer in India and the 2nd most common female cancer in the women aged 15 to 44 years in World(1) and India. About 527,624 new cases are diagnosed and 265,672 cervical cancer deaths occur annually in the World. Incidence and prevalence of cervical cancer remains high in developing countries due to lack of resources, lack of effective screening programmes and poorly organised health system aimed for detecting precancerous condition before they progress to invasive cancer. Colposcopy remains the reference standard for assessing the validity of all the screening procedures for cervical cancer. Colposcopy scoring systems provide an objective diagnosis to grade the severity of premalignant lesions and select patients who require treatment. A new scoring system, Swede score, has added lesion size as a parameter. Objective- This study aimed to evaluate the diagnostic efficacy of colposcopy using Swede score and to determine the degree of correlation between colposcopy impression and histopathology. MATERIALS AND METHODS This prospective study carried out in Rajiv Gandhi Government Women and Children Hospital (RGGWCH), Puducherry from February 2016-January 2017; 220 women aged 20 to 65 who met the selection criteria were included in the study. All women underwent colposcopy; the findings were scored by Swede score, biopsy taken from the abnormal areas. Patients in whom colposcopy was normal, biopsy was taken from the cervix within the transformation zone. RESULTS According to the Swede scoring system, 133 (60.45%) were benign cases, 64 (29.1%) women were diagnosed as LGL, 23 (10.45%) were diagnosed as HGL. As far as histologic results were concerned, 144 (65.45%) were benign showing chronic cervicitis, whereas 52 (23.64%), 24 (10.9%) were diagnosed as CIN 1 (LGL), HGL (CIN 2, CIN 3) respectively. CONCLUSION The âkâ value for the strength of correlation between colposcopy impression for CIN using Swede score and histopathology was k=0.73, for CIN 2+ it was k=0.92. Colposcopy by Swede score had a satisfactory sensitivity of 89.47% and specificity of 86.81% in the detection of CIN. Whereas in the detection of high-grade CIN (CIN 2+), Swede score colposcopy had a sensitivity of 91.67% and specificity of 99.49%.
Authors and Affiliations
Sudha Penumalli, Valsa Diana G, Kasthuri T. B
Keywords
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- EP ID EP279940
- DOI 10.14260/jemds/2017/1488
- Views 136
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