Objective To predict cervical cancer patients by endocervical curettage （ECC） during colposcopy, and evaluate the accuracy and diagnostic efficacy of ECC. Methods A total of 631 patients who underwent colposcopy and cervical biopsy with simultaneous ECC due to abnormal results of cervical cancer screening between January 2020 and October 2023 were selected as study subjects, and the histopathological results and ECC results were analyzed. Results According to the histopathological results, 22 cases of cervical cancer, 4 cases of adenocarcinomas, 66 cases of low-degree lesions, and 59 cases of high-degree lesions were detected in the 631 patients. With histopathological results as the gold standard, the accuracy of ECC in cervical cancer screening was 97.78%, the sensitivity was 81.82%, the specificity was 98.36%, the positive predictive value was 64.29%, the negative predictive value was 99.34%, and the Kappa=0.709; the accuracy of ECC in cervical intraepithelial lesion screening was 92.23%, the sensitivity was 88.00%, the specificity was 93.33%, the positive predictive value was 77.46%, the negative predictive value was 96.76%, and the Kappa=0.774. The results suggested good agreement of ECC with pathological examination results. Conclusion The use of ECC in colposcopy has great application value in early screening of cervical cancer patients, and this method can improve the sensitivity of early screening and reduce the rate of missed diagnosis, thereby reduce the morbidity and mortality of cervical cancer.