Karen Wernli, PhD, is a cancer epidemiologist and health services researcher whose work focuses on incorporating patient-centered outcomes to improve cancer care from prevention to survivorship. Her works spans many types of cancer, including breast, colorectal, lung, and ovarian. Her research strives to answer critical questions at the confluence of patients’ needs and clinical care.
Dr. Wernli recently completed a Patient-Centered Outcomes Research Institute (PCORI) project that compared breast magnetic resonance imaging (MRI) to mammography for women already treated for breast cancer. Called Surveillance Imaging Modalities for Breast Cancer Assessment (SIMBA), the 3-year study used data from the Breast Cancer Surveillance Consortium (BCSC) and engaged patients and stakeholders to determine the best information for patient and physician decision-making. Dr. Wernli’s team translated that information into a new decision aid for breast cancer survivors. PCORI has recognized this work nationally and pointed to SIMBA as a model for effective patient engagement.
Dr. Wernli’s other breast cancer projects include a National Cancer Institute (NCI)-funded study to examine trends and outcomes related to the mandatory notification of breast density that has been enacted in many states. With colleagues at Georgetown University, she is working on another NCI-funded study looking at the best ways to inform women about breast cancer risk and options for managing it. She is collaborating with Dr. Natasha Stout at Harvard University, using national claims data, to study the impact of density legislation on changes in breast imaging tests. Research from these studies has been presented at the American Society for Preventive Oncology, International Cancer Research Network, and International Breast Density & Cancer Risk Assessment Workshop.
In the Clare Project, Dr. Wernli launched a new direction in adolescent and young adult (AYA) cancer patients. Working with colleagues at KPWHRI, she evaluated patient, caregiver, and provider perspectives regarding medical decision making in patients with advanced cancer. Using novel methods, all perspectives were garnered through social media recruitment. With NCI-funding, she has evaluated national claims data of end-of-life care in AYA populations. Future research will build on these initial efforts.
Finally, Dr. Wernli is establishing a patient advisory board among Kaiser Permanente members participating in lung cancer screening. She is also evaluating cancer screening processes through quantitative and qualitative methods.
Dr. Wernli joined KPWHRI in 2009, following post-doctoral training at the Fred Hutchinson Cancer Research Center. She is a member of American Society for Preventive Oncology, Society for Epidemiologic Research, American Society for Clinical Oncology, and American Association for Cancer Research. She is a standing reviewer for American Cancer Society, and routinely reviews grants for the National Institutes of Health. She is also an affiliate associate professor of health services at the University of Washington.
Breast, lung, colorectal, ovarian, skin, and endometrial cancer; screening and surveillance; survivorship; patient-centered care; biostatistics; mammography; mammographic breast density; low-dose CT (LDCT); systematic reviews
Comparative effectiveness research; health outcomes research
Cancer screening and surveillance
Patient engagement, stakeholder engagement, qualitative research methods
Textile workers in China
Henderson LM, Ichikawa L, Buist DSM, Lee JM, Bush M, Johnson D, Onega T, Nekhlyudov L, Kerlikowske K, Miglioretti DL, Sprague BL, Wernli KJ. Patterns of breast imaging use among women with a personal history of breast cancer. J Gen Intern Med. 2019 Aug 13. doi: 10.1007/s11606-019-05181-6. [Epub ahead of print].
Wernli KJ, Brandzel SD, Buist DM, Bush M, DeMartini W, Ichikawa L, Haas C, Henderson LM, Johnson D, Kerlikowske K, McColgin D, Miglioretti DL, Nekhlyudov L, Onega T, Rosenberg DE. Is breast MRI better at finding second breast cancers than mammograms alone for breast cancer survivors? Washington, DC: Patient-Centered Outcomes Research Institute (PCORI). 2019. https://doi.org/10.25302/5.2019.CE.13046656.
Kerlikowske K, Sprague BL, Tosteson ANA, Wernli KJ, Rauscher GH, Johnson D, Buist DSM, Onega T, Henderson LM, O'Meara ES, Miglioretti DL. Strategies to identify women at high risk of advanced breast cancer during routine screening for discussion of supplemental imaging. JAMA Intern Med. 2019 Jul 1. pii: 2737320. doi: 10.1001/jamainternmed.2019.1758. [Epub ahead of print]. PubMed
Wernli KJ, Ichikawa L, Kerlikowske K, Buist DSM, Brandzel SD, Bush M, Johnson D, Henderson LM, Nekhlyudov L, Onega T, Sprague BL, Lee JM, Lehman CD, Miglioretti DL. Surveillance breast MRI and mammography: comparison in women with a personal history of breast cancer. Radiology. 2019 Jun 4:182475. doi: 10.1148/radiol.2019182475. [Epub ahead of print]. PubMed
Wernli KJ, Ichikawa K, Kerlikowske K, Buist DSM, Brandzel SD, Bush M, Johnson D, Henderson LM, Nekhlyudov L, Onega T, Sprague BL, Lee JM, Lehman C, Miglioretti DL. Surveillance breast MRI and mammography performance measures in women with a personal history of breast cancer. Radiology. 2019 Aug;292(2):311-318. doi: 10.1148/radiol.2019182475. Epub 2019 Jun 4. PubMed
Breen N, Skinner CS, Zheng Y, Inrig S, Corley DA, Beaber EF, Garcia M, Chubak J, Doubeni C, Quinn VP, Haas JS, Li CI, Wernli KJ, Klabunde CN. Time to Follow-up After Colorectal Cancer Screening by Health Insurance Type. Am J Prev Med. 2019;56(5):e143-e152. doi: 10.1016/j.amepre.2019.01.005. PubMed
Haas CB, Phipps AI, Hajat A, Chubak J, Wernli KJ. Time to fecal immunochemical test completion for colorectal cancer screening. Am J Manag Care. 2019 Apr;25(4):174-180. PubMed
Knerr S, Bowles EJA, Leppig KA, Buist DSM, Gao H, Wernli KJ. Trends in BRCA test utilization in an integrated health system, 2005-2015. J Natl Cancer Inst. 2019 Feb 8. pii: 5310095. doi: 10.1093/jnci/djz008. [Epub ahead of print]. PubMed
Arasu VA, Miglioretti DL, Sprague BL, Alsheik NH, Buist DSM, Henderson LM, Herschorn SD, Lee JM, Onega T, Rauscher GH, Wernli KJ, Lehman CD, Kerlikowske K. Population-based assessment of the association between magnetic resonance imaging background parenchymal enhancement and future primary breast cancer risk. J Clin Oncol. 2019 Apr 20;37(12):954-963. doi: 10.1200/JCO.18.00378. Epub 2019 Jan 9. PubMed
Beaber EF, Sprague BL, Tosteson ANA, Haas JS, Onega T, Schapira MM, McCarthy AM, Li CI, Herschorn SD, Lehman CD, Wernli KJ, Barlow WE. Multilevel predictors of continued adherence to breast cancer screening among women ages 50-74 years in a screening population. J Womens Health (Larchmt). 2018 Nov 27. doi: 10.1089/jwh.2018.6997. [Epub ahead of print]. PubMed
A Kaiser Permanente-led BCSC study is among the largest ever to evaluate adding MRI surveillance for breast cancer survivors.
The first Clare Project study asked about values and care preferences. Project leaders are now building on that foundation.
Kaiser Permanente Washington has been part of the national Breast Cancer Surveillance Consortium since 1994. Learn more about the Kaiser Permanente Washington Breast Cancer Surveillance Registry.
Digital breast tomosynthesis reduced patient recalls with no change in cancer detection, study shows.
Drs. Rosenberg and Wernli lead team with first-hand knowledge of complex conditions and care.
Read it in Healthy Findings.