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The Performance of Modified Swede Colposcopic Index to Predict High Grade Cervical Intraepithelial Neoplasia and Cervical Cancer in the Real Clinical Practice, an External Validation Study

  • 0Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Police general hospital, Rajprasong Intersection Pathuwan Bangkok, Thailand.
Asian Pacific Journal of Cancer Prevention : Apjcp +

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August 24, 2025

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August 24, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

The modified Swede colposcopic index (MSCI) shows high specificity for detecting cervical intraepithelial neoplasia grade 2-3 or cancer (CIN2+) in women with abnormal screening. It also demonstrated good inter-rater and excellent intra-rater reliability.

Area Of Science

  • Gynecology
  • Oncology
  • Diagnostic Accuracy

Background

  • Cervical cancer screening relies on accurate colposcopy.
  • The modified Swede colposcopic index (MSCI) is a tool used in colposcopy.
  • External validation and reliability of MSCI are crucial for clinical application.

Purpose Of The Study

  • To assess the external validity of MSCI in predicting cervical intraepithelial neoplasia grade 2-3 or cancer (CIN2+).
  • To evaluate the inter-rater and intra-rater reliability of MSCI in women with abnormal cervical cancer screening.
  • To determine the diagnostic performance of MSCI using sensitivity, specificity, PPV, and NPV.

Main Methods

  • A prospective study was conducted on 118 women aged 25-65 with abnormal cervical cancer screening results (ASC-US or higher and/or high-risk HPV).
  • Participants were previously undiagnosed with CIN2+.
  • Gynecologic oncologists applied the MSCI, and its effectiveness in detecting CIN2+ was evaluated.

Main Results

  • MSCI achieved a sensitivity of 46.9%, specificity of 87.2%, PPV of 57.7%, and NPV of 81.5%.
  • Overall accuracy of MSCI was 76.27%.
  • Inter-rater reliability was good (ICC=0.77), and intra-rater reliability was excellent (ICC=0.98).

Conclusions

  • The MSCI demonstrates high specificity in identifying CIN2+ in a real-world clinical setting.
  • The index maintains acceptable sensitivity for predicting CIN2+.
  • The MSCI is a reliable tool for colposcopic assessment in women with abnormal cervical cancer screening.

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