Dr Jemma Longley, Consultant Medical Oncologist at University Hospital Southampton and Honorary Senior Clinical Lecturer in the Faculty of Medicine, is leading innovative research into one of the biggest challenges in cancer care: the early detection of ovarian cancer. Her work focuses on detecting the early signs of disease through studying microRNAs – molecules that help control how cells behave.
She is Chief Investigator of the VIOLET study, exploring whether vaginal fluid collected using a diagnostic tampon can detect cancer before symptoms appear. This approach could lead to the first non-invasive monitoring test for women at high risk, including those with a BRCA gene mutation.
Around 21 women in the UK are diagnosed with ovarian cancer every day, but only about 27% of cases are found early, when treatment is most effective. Most diagnoses happen after the cancer has already spread, reducing five-year survival rates to below 30%.
Some women face an even higher risk. Those with a BRCA gene mutation can have up to a 44% lifetime risk of developing ovarian cancer.
Dr Longley’s PhD has shown that microRNAs play an important role in the tumour microenvironment (the environment that helps cancer cells grow and spread). Unlike other methods, such as circulating tumour DNA tests, which work better in later-stage cancer, microRNAs may provide earlier signals that cancer is developing.
The VIOLET study (Vaginal fluid derived biomarkers in the early detection and monitoring of ovarian cancer in high-risk women) is a five-year study based at the University of Southampton. It follows women with suspected or confirmed ovarian cancer, as well as women with BRCA mutations.
Participants provide samples of tissue, blood, urine and vaginal fluid. The vaginal fluid is collected using a specially designed diagnostic tampon developed with industry partner Daye (https://www.yourdaye.com/).
Funded by the Eve Appeal, the study asks a simple but important question: can microRNAs found in vaginal fluid detect early, pre-cancerous changes? These include STIC lesions, which are now believed to be an early stage of the most common type of ovarian cancer.
A secondary focus is the vaginal microbiome to see if it plays a role in cancer risk or how patients respond to treatment.
If successful, the VIOLET study could lead to the first self-administered screening test for ovarian cancer. Initially aimed at high-risk women, it could eventually be used for population-level screening. More broadly, this work could change how we detect not only ovarian cancer but other gynaecological cancers too, potentially leading to a single test that screens for multiple conditions.
Earlier detection would not only save lives but also reduce pressure on the NHS: a 20-30% increase in early diagnoses could save an estimated £15-40 million each year by reducing emergency care and the need for intensive treatments.
The study has already gained strong media attention, showing clear public interest. It also supports the NHS Women’s Health Strategy by focusing on accessible, patient-centred care and addressing gaps in women’s health research.
“Promoting the VIOLET study has also been about raising awareness of ovarian cancer,” explains Dr Longley. “One of the biggest challenges is that its symptoms are often vague and difficult to identify in clinical settings – things like bloating or menopausal-type symptoms. Both doctors and women need to be more aware of these signs so the disease can be detected earlier, and that’s something we hope this study will help to change.”
Dr Jemma Longley’s research offers a new way of thinking about cancer detection. Instead of relying on scans or blood tests alone, it focuses on biological signals from the reproductive tract itself.
By combining scientific insight with a simple, user-friendly test, the VIOLET study could lead to a major breakthrough in early diagnosis. This could improve survival rates, reduce the need for preventative surgery, and support wider screening programmes in the future.
Ultimately, Dr Longley’s research highlights the importance of new ideas in women’s health – helping to close long-standing gaps and improve outcomes for future generations.
