Abstract: Objective To investigate the significance of HPV E6/E7 mRNA test combined with Thinprep cytologic test (TCT) in the early screening of cervical lesions in rural middle-aged women. Methods The early screening for cervical cancer and precancerous lesions by using HPV E6/E7 mRNA test and TCT was performed in 360 rural middle-aged women in our hospital between April, 2015 and December, 2016, in which the histological examination was used as the gold standard to evaluate the effect of the combined test. Results The positive rate of HPV E6/E7 mRNA in CIN group was 86.18%, which was significantly higher than that of chronic inflammation group (29.33%), χ²=114.074, P<0.05. The positive rate of HPV E6/E7 mRNA for CIN1, CIN2, CIN3 and patients with cervical cancer were 79.59%, 86.84%, 88.46% and 100.00%, respectively, which showed an increased trend. The positive rate by TCT test in CIN group was 68.42, which was significantly higher than that of chronic inflammation group (22.12%), χ²=77.476, P<0.05. The positive rate by TCT test in CIN1, CIN2, CIN3 and cervical cancer was 57.14%, 68.42%, 76.92% and 76.92%, respectively, which showed an increased trend. The mean test positive rate of HPV E6/E7 mRNA (54.17%) and TCT (38.89%) had consistency (r=0.428, P<0.05). The sensitivity and negative predictive value of HPV E6/E7 mRNA test combined with TCT were significantly higher than the result by one of them (P<0.05). There was no significant difference in the specificity and positive predictive value among the three methods (P>0.05). The diagnostic accuracy of the combined test was 80.83%, which was higher than that by TCT test. Conclusion E6/E7 mRNA test combined with TCT can improve diagnostic efficiency, and advantage of noninvasive test. It is worthy of popularization and application in the screening of precancerous cervical lesions.