OBJECTIVE: To investigate the clinical value of miR-216a-5p and miR-34a in early screening for cervical cancer (CC). METHODS: 99 patients were selected and classified into a cervical cancer group, a precancerous lesion group, and a chronic cervicitis group, with 33 patients in each group. The miR-216a-5p and miR-34a levels in the morning urine samples of patients in the three groups were detected. Additionally, the urine samples of CC patients were analyzed and their cervical tissues examined to confirm the presence of Human Papilloma Virus (HPV) infection. The differences in the levels of miR-216a-5p and miR-34a in CC patients exhibiting varying clinical features and the clinical values of the two biomarkers in identifying CC were analyzed. Patients in the cervical cancer group were divided into a recurrence group and a non-recurrence group, after which their levels of miR-216a-5p and miR-34a were analyzed. These patients were subsequently divided into a high-expression group and a low-expression group with the aforementioned biomarker levels in the non-recurrence group as cutoff values. The progression-free survival was compared between the low- and high-expression groups. RESULTS: Sensitivity and specificity of the urine sample test for HPV infection were 85.19% and 93.33%, respectively. Compared to chronic cervicitis group and precancerous lesion groups, or the non-recurrence group, the levels of miR-216a-5p and miR-34a in both the cervical cancer group and recurrence group were significantly lower (P <
0.05). CC patients with moderately to poorly differentiated tumor cells, an infiltration depth of the muscle layer >
1/2, lymph node metastasis, parametrial infiltration, or vascular invasion had significantly lower levels of miR-216a-5p and miR-34a than those without these risk factors (P <
0.05). The AUC for the application of the two biomarkers in diagnosing CC individually or in combination, or in forecasting recurrence, was greater than 0.8. Additionally, the cumulative progression-free survival was shorter in the low-expression group compared to the high-expression group. CONCLUSION: Use of morning urine samples for testing HPV infection shows high sensitivity and specificity. Moreover, the miR-216a-5p and miR-34a levels were closely associated with the progression and recurrence of CC.