NCI Cervical Cancer ‘Last Mile’ Initiative


Following substantial reductions in cervical cancer incidence rates in the United States in the last half of the twentieth century, rates have plateaued. For the past two decades, despite the availability of highly sensitive screening methods such as human papillomavirus (HPV) testing, over 13,000 women continue to be diagnosed with and over 4,000 women continue to die of cervical cancer annually. Over half of the new cervical cancer cases in the US are among women who have been never screened or who are infrequently screened, reflecting barriers presented by socioeconomic disparities, geographic inaccessibility, among other factors. An alternative screening approach that has been widely evaluated to overcome these barriers is self-collection of samples (‘self-sampling’) by women themselves and sending the sample for HPV testing. This approach offers several benefits including ease of collection at a time/place of women’s choice without a need for a clinic appointment or speculum examination. This intervention has significant potential to expand cervical cancer screening to never screened or under-screened women and address a pressing public health concern of lack of access to screening as a health disparity.

BSA Presentation

Presentation to the NCI Board of Scientific Advisors (PDF, 1.13 MB)
By Vikrant Sahasrabuddhe, M.B.B.S., Dr.P.H.
Please note this PDF may not have the most updated information about the 'Last Mile Initiative'.

‘Last Mile’ Initiative

The National Cancer Institute (NCI) Division of Cancer Prevention (DCP) has developed the ‘Last Mile’ Initiative (LMI) as a public private partnership between several stakeholders (including federal agencies, industry partners, and professional societies/clinical practice guidelines organizations) to validate self-sampling-based HPV testing approaches as a comparable (non-inferior) alternatives to provider-collected cervical specimen for HPV testing in cervical cancer screening, and accelerate progress towards regulatory approvals. As part of this initiative, the NCI will support a nationwide, multicentric screening trial, the “Last Mile Initiative Self-sampling for HPV testing to Improve Cervical Cancer Prevention” Trial (‘LMI-SHIP Trial’) in diverse delivery settings.

This study will be supported by a Research and Development (R&D) contract. Further information will be posted here in 2022.

For more information, please contact Vikrant Sahasrabuddhe, M.B.B.S., Dr.P.H. in the NCI Division of Cancer Prevention.