Objective To evaluate the efficacy of human papillomavirus E6/E7 (HPV E6/E7) mRNA combined with colposcopy in screening cervical cancer and precancerous lesions.

Methods A total of 480 patients with suspected cervical precancerous lesions in the hospital from July 2022 to December 2024 were retrospectively selected as research objects. All the patients underwent HPV E6/E7 mRNA testing, colposcopy, and pathological examination. Taking the pathological examination results as the diagnostic golden standard, the diagnostic values of HPV E6/E7 mRNA and colposcopy alone as well as their combination were analyzed.

Results The pathological examination results of 480 patients showed that there were 192 negative cases, including 1 case of normal cervix and 191 cases of benign lesions; there were 288 positive cases, including 133 cases of low-grade squamous intraepithelial lesions (LSIL), 110 cases of high-grade squamousintraepithelial lesions (HSIL), and 45 cases of cervical squamous cell carcinoma (SCC). The colposcopy results showed 211 true-positive cases and 138 true-negative cases; the HPV E6/E7 mRNA test results showed 199 true-positive cases and 137 true-negative cases; the combined test results showed 239 true-positive cases and 174 true-negative cases. The sensitivity (95.22%), specificity (75.98%), accuracy (86.04%), positive predictive value (81.29%), and negative predictive value (93.55%) of the combined test were significantly higher than those of each individual test (P < 0.001). Moreover, the consistency between the combined test and pathological results (Kappa=0.718, P < 0.001) was also significantly higher than that of each individual test.

Conclusion Compared with HPV E6/E7 mRNA or colposcopy alone, the combined test has higher clinical application value in screening of cervical precancerous lesions and cervical cancer, shows stronger consistency with pathological results, and is of great significance for the early differential diagnosis of cervical precancerous lesions and cervical cancer.