Introduction Cervical cancer (CC) is the second most common malignancy among women in Bangladesh which is preceded by a precancerous phase called CIN. This facilitates early detection of CIN and thereby making CC preventable. Colposcopic scoring systems can select patients who require treatment. This study was performed to compare between two colposcopic scoring system for selecting the patients with cervical pre-cancer for treatment as a single visit approach.
Methods This prospective study enrolled 300 women aged 18 years or over with abnormal cervical screening test. All women underwent colposcopy by both Reid colposcopic index and Swede score. Biopsy was taken in all cases.The performance of both scores was assessed.
Results A total of 54 (18%) CIN2+ lesions were detected. Reid colposcopic index at a cutoff of 5 had sensitivity, specificity, positive predictive value, and negative predictive value for detecting CIN2+ was 87.62%, 94.71%, 87.62%, and 94.71%, respectively. Using Swede score at a cutoff 5 sensitivity, specificity, positive predictive value, and negative predictive value were 96.59%, 89.58%, 77.27%, and 98.62%, respectively and at cutoff 8 were 68%, 98.03%, 94.44%, and 86.2%, respectively. The strength of correlation between the two scores was 0.603.
Conclusion/Implications There was a good association between two colposcopic scoring. Swede score at cut off 5 can be used for screening, whereas cut off 8 can be used for treatment purpose as single visit approach. Thus colposcopy really matters in eliminating cervical cancer in low resource setting where the high performance test for the screening are still evolving.
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