obstetrics-gynaecology

Swede Score for Colposcopy

5-component colposcopic scoring system for predicting severity of cervical intraepithelial neoplasia (CIN). Validated in Scandinavian and UK studies. Score ≥8 = high risk CIN 2+; score 0–4 = low risk.

Acetowhite reaction*

Margins*

Vascular pattern*

Lesion size (number of quadrants / cervical thirds involved)*

Iodine staining (Lugol's iodine)*

Score interpretation

Low Risk 0–4

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

Intermediate Risk 5–7

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

High Risk 8–11

Swede Score ≥8 — high risk; CIN 2/3 likely

→ 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

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.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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