Diagnostic accuracy of a systematic approach using Swedescore versus conventional colposcopy for the detection of cervical intraepithelial neoplasia grade 2 or worse: A multicenter, non‐randomized clinical study

@article{knudsen2026diagnostic,
  title = {{Diagnostic accuracy of a systematic approach using Swedescore versus conventional colposcopy for the detection of cervical intraepithelial neoplasia grade 2 or worse: A multicenter, non‐randomized clinical study}},
  author = {Ane‐Kersti Skaarup Knudsen and Line Winther Gustafson and Berit Bargum Booth and Tina Hovgaard Randrup and Ulrik Schiøler Kesmodel and Björn Strander and Ameli Tropé and Pekka Nieminen and Anne Hammer and Attila Botházi and Attila Botházi and Eva Hauge and Christina Blach Kristensen and Helene Nortvig and Rikke Guldberg and Siv Lykke Jørgensen and Corina Ülgüt and Lærke Müller Olsen and Parag Deepak Dabir},
  journal = {Acta Obstetricia et Gynecologica Scandinavica},
  year = {2026},
  month = nov,
  doi = {10.1111/aogs.70375},
  url = {https://doi.org/10.1111/aogs.70375},
  note = {CC BY-NC-ND 4.0},
}

TY  - JOUR
TI  - Diagnostic accuracy of a systematic approach using Swedescore versus conventional colposcopy for the detection of cervical intraepithelial neoplasia grade 2 or worse: A multicenter, non‐randomized clinical study
AU  - Ane‐Kersti Skaarup Knudsen
AU  - Line Winther Gustafson
AU  - Berit Bargum Booth
AU  - Tina Hovgaard Randrup
AU  - Ulrik Schiøler Kesmodel
AU  - Björn Strander
AU  - Ameli Tropé
AU  - Pekka Nieminen
AU  - Anne Hammer
AU  - Attila Botházi
AU  - Attila Botházi
AU  - Eva Hauge
AU  - Christina Blach Kristensen
AU  - Helene Nortvig
AU  - Rikke Guldberg
AU  - Siv Lykke Jørgensen
AU  - Corina Ülgüt
AU  - Lærke Müller Olsen
AU  - Parag Deepak Dabir
PY  - 2026
DA  - 2026/11/03
JO  - Acta Obstetricia et Gynecologica Scandinavica
DO  - 10.1111/aogs.70375
UR  - https://doi.org/10.1111/aogs.70375
AB  - Introduction: Globally, colposcopy is often performed by non‐experts with no certification or routine use of colposcopic scoring tools. A systematic colposcopic scoring tool, the Swedescore, has been developed to enhance the detection rate of cervical intraepithelial neoplasia grade 2 or worse (CIN2+). We aimed to compare the diagnostic accuracy of two colposcopy methods (systematic use of the Swedescore versus conventional colposcopy) for detecting CIN2+.  Material and Methods: This multicenter, non‐randomized clinical study included women (23–65 years) referred for colposcopy and with a visible transformation zone (type 1 and 2). Colposcopy was performed using the systematic scoring tool, Swedescore, or the conventional method. All women had four cervical biopsies collected. Colposcopists collected lesion‐directed biopsies (target biopsies) from abnormal areas with or without non‐lesion‐directed biopsies (random biopsies) from areas that appeared normal. The gold standard was the most severe diagnosis (CIN2+) based on all four biopsies. The primary outcome was CIN2+. We calculated sensitivity (SN), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) with 95% confidence intervals and compared results between the two methods. Results were stratified by age, body mass index (BMI), human papillomavirus (HPV) vaccination status, screening method, index cytology, index HPV type, and colposcopists. Clinical Trial Registration ClinicalTrials.gov NCT05870787.  Results: Among 929 women included (Swedescore: 534, conventional: 395), the diagnostic accuracy for the detection of CIN2+ was slightly higher with the Swedescore compared to the conventional method (SN: 84.7% vs. 77.8%, SP: 37.3% vs. 30.9%, PPV: 47.6% vs. 43.9%, NPV: 78.3% vs. 66.7%). Sensitivity for CIN2+ was significantly higher with the Swedescore compared to the conventional method in women ≥50 years (92.9% vs. 62.5%), those with high‐grade cytology (92.4% vs. 83.2%), and when colposcopy was performed by residents (91.8% vs. 70.6%). Regardless of HPV vaccination status and screening method, the Swedescore performed slightly better than the conventional method, although the differences were not statistically significant.  Conclusions: Our findings may suggest that, in a non‐expert setting, a systematic colposcopic examination using the Swedescore was associated with a slightly higher diagnostic accuracy for detecting CIN2+ compared to the conventional method. These findings should be interpreted considering baseline imbalances between the two methods.
SN  - 0001-6349
SN  - 1600-0412
ER  -