Abstract: Objective To analyze the effect of HPV primary screening with HPV hybrid capture test and triage test with Pap smear of rural women for cervical cancer in China. Methods HPV test were performed for rural women aged 35-64 as primary cervical cancer screening at 2015. Pap smear was conducted on HPV test-positive women. Colposcopy was conducted if Pap smear results were above ASC-US. Pathology-confirmed biopsies were implemented for final diagnosis. Surgery was performed on women with pathological results above CIN2. Results The HPV positive rate was 10.65% when using the strategy of DH2 test as primary screening method and Pap smear as a triage testing. The number of women with ASC-US and above was 150, and the referral rate of women who accepted colposcopy was 3.57%, the participation rate was 100%. The detection number(rate) of CIN1, CIN2 and above and CIN3 and above were16(0.38%), 29(0.69%)and 15(0.36%), respectively. There were no cervical cancer cases in this study. Conclusions HPV test as primary screening method and Pap smear as a triage test can decrease the colposcopy referral,and the detection rate of cervical pre cancer and cancer was high. According to the diagnostic level of local hospitals, Pap smear as a triage test should be considered. The detection rate of cervical pre cancer and cancer was higher when using the strategy of HPV test without any triage test. We should improve the technological level of clinical cytologic diagnosis among doctors in rural areas to detect more cervical lesions.