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Swede Score

Five-feature colposcopic score predicting a high-grade cervical lesion (CIN 2+).

Swede Score
Aceto-uptake
Margins / surface
Vessels
Lesion size
Iodine staining
Result0 points

Low probability of a high-grade lesion (CIN 2+).

Aceto-uptake
0
Margins/surface
0
Vessels
0
Lesion size
0
Iodine staining
0

When to use

  • Structured colposcopic scoring of the most abnormal cervical area to estimate probability of a high-grade (CIN 2+) lesion and guide the decision to biopsy.

Formula

Swede score = aceto-uptake (0-2) + margins/surface (0-2) + vessels (0-2) + lesion size (0-2) + iodine staining (0-2). Range 0-10; higher scores favour high-grade disease.

Pearls and pitfalls

  • A score of 8 or more has been reported as highly specific for a high-grade lesion, supporting a "see-and-treat" approach in some protocols.

References

  1. Strander B, Ellstrom-Andersson A, Franzen S, Milsom I, Radberg T. The performance of a new scoring system for colposcopy in detecting high-grade dysplasia in the uterine cervix. Acta Obstet Gynecol Scand. 2005;84(10):1013-7.
  2. Bowring J, Strander B, Young M, Evans H, Walker P. The Swede score: evaluation of a scoring system designed to improve the predictive value of colposcopy. J Low Genit Tract Dis. 2010;14(4):301-5.