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
Aiello Bowles EJ, Wernli KJ, Gray HJ, Bogart A, Delate T, O’Keefe-Rosetti M, Nekhylyudov L, Trice Loggers E. Diffusion of intraperitoneal chemotherapy in women with advanced ovarian cancer in community settings 2003-2008: the effect of the NCI clinical recommendation. Front Oncol. 2014 Mar 10;4:43. doi: 10.3389/fonc.2014.00043. eCollection 2014. PubMed
Onega T, Weiss J, Kerlikowske K, Wernli K, Buist DS, Henderson LM, Goodrich M, Alford-Teaster J, Virnig B, Tosteson AN, DeMartini W, Hubbard R. The influence of race/ethnicity and place of service on breast reconstruction for Medicare beneficiaries with mastectomy. Springerplus. 2014 Aug 8;3:416. doi: 10.1186/2193-1801-3-416. eCollection 2014. PubMed
Wernli KJ, DeMartini WB, Ichikawa L, Lehman C, Onega TL, Kerlikowske K, Gellar BM, Hofmann M, Yankaskas BC; for the Breast Cancer Surveillance Consortium. Patterns of breast magnetic resonance imaging use in community practice. JAMA Intern Med. 2014 Jan;174(1):125-32. doi: 10.1001/jamainternmed.2013.11963. Epub 2013 Nov 18. PubMed
Wernli KJ, O’Meara E, Kerlikowske K, Miglioretti D, Muller CY, Onega T, Sprague B, Henderson L, Buist DS. Investigation of mammographic breast density as a risk factor for ovarian cancer. J Nat Cancer Inst. 2014 Jan 1;106(1):djt341. doi: 10.1093/jnci/djt341. Epub 2013 Dec 5. PubMed
O'Meara ES, Zhu W, Hubbard RA, Braithwaite D, Kerlikowske K, Dittus KL, Geller B, Wernli KJ, Miglioretti DL. Mammographic screening interval in relation to tumor characteristics and false-positive risk by race/ethnicity and age. Cancer. 2013 Nov 15;119(22):3959-67. doi: 10.1002/cncr.28310. Epub 2013 Aug 26. PubMed
Li W, Ray RM, Thomas DB, Yost M, Davis S, Breslow N, Gao DL, Fitzgibbons ED, Camp JE, Wong E, Wernli KJ, Checkoway H. Occupational exposure to magnetic fields and breast cancer among women textile workers in Shanghai, China. Am J Epidemiol. 2013 Oct 1;178(7):1038-45. doi: 10.1093/aje/kwt161. Epub 2013 Sep 15. PubMed
Wernli KJ, Kitahara CM, Tamers SL, Al-Temimi MH, Braithwaite D. Undertaking cancer research in international settings: report from the American Society for Preventive Oncology Special Interest Group on International Issues in Cancer. Cancer Epidemiol Biomarkers Prev. 2013 Sep;22(9):1638-41. doi:10.1158/1055-9965.EPI-13-0655. Epub 2013 Jul 11. PubMed
Wernli KJ, Rutter CM, Dachman AH, Zafar HM. Suspected extracolonic neoplasms detected on CT colonography: literature review and possible outcomes. Acad Radiol. 2013 Jun;20(6):667-74. doi: 10.1016/j.acra.2013.01.017. Epub 2013 Mar 1. PubMed
Kerlikowske K, Zhu WW, Hubbard R, Gellar B, Dittus K, Braithwaite D, O’Meara E, Wernli KJ, Miglioretti D, for the Breast Cancer Surveillance Consortium. Outcomes of screening mammography by frequency, breast density and postmenopausal hormone therapy. JAMA Intern Med. 2013 May 13;173(9):807-16. doi:10.1001/jamainternmed.2013.307. Epub 2013 Mar 18. PubMed
Wernli KJ, Inadomi JM. Anesthesia for colonoscopy: too much of a good thing? Comment on "Complications following colonoscopy with anesthesia assistance." JAMA Intern Med. 2013 Apr 8;173(7):556-8. doi: 10.1001/jamainternmed.2013.4071. Epub 2013 Mar 11. PubMed
An epidemiologist identifies who is appropriately undergoing this imaging for breast cancer and who is not.
Now’s the time, Dr. Wernli says, to weigh in on lowering eligible age and pack-years smoked.
There’s much confusion about the new disease, but numbers don’t lie. The challenge is finding the right ones.
MedPage Today, Jul 24, 2019
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.
Reuters (via Medscape), Jun 7, 2019