Swede Score for Colposcopy
5-item colposcopic score (aceto uptake, margins/surface, vessels, lesion size, iodine staining; each 0–2, total 0–10) for predicting high-grade CIN (CIN 2+). Score ≥ 8 = high-grade lesion likely; 0–4 = low risk.
Score interpretation
Swede Score 0–4 — low risk of CIN 2 or worse
→ Biopsy directed by clinical judgement; if no biopsy taken, repeat smear + HPV in 12 months; conservative management appropriate for CIN 1
Swede Score 5–7 — intermediate; CIN 1–2 possible
→ Colposcopy-directed punch biopsy; await histology; if CIN 2 on biopsy, LLETZ or cold coagulation; if CIN 1, follow local surveillance protocol
Swede Score ≥8 — high-grade lesion likely (90 % specificity for CIN 2+ in the original study)
→ Consider see-and-treat LLETZ at colposcopy; confirm histology; HPV test of cure at 6 months; if histology shows CIN 3, confirm clear margins; if margins involved, repeat LLETZ or consider hysterectomy in completed family
Interpretation bands for the Swede Score. Apply clinical judgement and local guidance.
References
- Strander B, et al. 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):1013–1017.
- Bowring J, et al. The Swede score: evaluation of a scoring system designed to improve the predictive value of colposcopy. J Low Genit Tract Dis. 2010;14(4):301–305.
Related
Curated clinical cross-links plus same-class fallbacks.
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.