宫颈癌仍然是一个重大的公共卫生问题，特别是在筛查率较低的地区。本研究评估了自我采样和 7 型 HPV mRNA E6/E7 检测在改善墨西哥转诊人群宫颈癌筛查结果方面的有效性。一组 418 名年龄 25 至 65 岁的墨西哥女性参与了这项研究，她们因细胞学结果异常而转诊接受阴道镜检查和活检 (ASC-US)。使用 14 型 HPV DNA 测试和 7 型 HPV mRNA E6/E7 测试对自身样本进行分析。该研究评估了敏感性、特异性、阳性预测值 (PPV) 以及阴道镜检查检测 CIN3 病变的必要性。还通过问卷调查评估了参与者对自我抽样的接受程度。与 14 型 HPV DNA 检测（特异性：45.8%，p < 0.001）相比，7 型 HPV mRNA E6/E7 检测在 CIN3 检测方面表现出同等的敏感性，但显着更高的特异性（77.0%）和 PPV（特异性：45.8%，p < 0.001）。使用 HPV mRNA 检测作为分诊工具，将每个检测到的 CIN3 病例所需的阴道镜检查次数从 16.6 次减少到 7.6 次（p < 0.001）。自我采样在参与者中得到了高度认可，大多数人表示对执行该程序充满信心，不适感最小，并且愿意在家中进行自我采样。自我采样与 7 型 HPV mRNA E6/E7 检测相结合，提供了一种有前途的策略，通过提高可及性和确保精确诊断来加强宫颈癌筛查。实施这些方法可能会显着降低宫颈癌的发病率和死亡率，特别是在服务不足的人群中。未来的研究应重点关注将这些方法纳入国家筛查计划的长期影响，并探索广泛实施的成本效益。

Cervical cancer remains a significant public health issue, particularly in regions with low screening uptake. This study evaluates the effectiveness of self-sampling and the 7-type HPV mRNA E6/E7 test in improving cervical cancer screening outcomes among a referral population in Mexico. A cohort of 418 Mexican women aged 25 to 65, referred for colposcopy and biopsy due to abnormal cytology results (ASC-US+), participated in this study. Self-samples were analyzed using both the 14-type HPV DNA test and the 7-type HPV mRNA E6/E7 test. The study assessed the sensitivity, specificity, positive predictive value (PPV), and the necessity of colposcopies to detect CIN3+ lesions. Participant acceptability of self-sampling was also evaluated through a questionnaire. The 7-type HPV mRNA E6/E7 test demonstrated equivalent sensitivity but significantly higher specificity (77.0%) and PPV for CIN3+ detection compared to the 14-type HPV DNA test (specificity: 45.8%, p < 0.001). The use of the HPV mRNA test as a triage tool reduced the number of colposcopies needed per CIN3+ case detected from 16.6 to 7.6 (p < 0.001). Self-sampling was highly accepted among participants, with the majority reporting confidence in performing the procedure, minimal discomfort, and willingness to undertake self-sampling at home. Self-sampling combined with the 7-type HPV mRNA E6/E7 testing offers a promising strategy to enhance cervical cancer screening by improving accessibility and ensuring precise diagnostics. Implementing these app roaches could lead to a significant reduction in cervical cancer morbidity and mortality, especially in underserved populations. Future research should focus on the long-term impact of integrating these methods into national screening programs and explore the cost-effectiveness of widespread implementation.