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
Braithwaite D, Zhu W, Hubbard RA, O'Meara ES, Miglioretti DL, Geller B, Dittus K, Moore D, Wernli KJ, Mandelblatt J, Kerlikowske K, for the Breast Cancer Surveillance Consortium. Screening outcomes in older U.S. women undergoing multiple mammograms in community practice: does interval, age or comorbidity score affect tumor characteristics or false positive rates? J Natl Cancer Inst. 2013 Mar 6;105(5):334-41. doi: 10.1093/jnci/djs645. Epub 2013 Feb 5. PubMed
Passarelli MN, Phipps AI, Potter JD, Makar KW, Coghill AE, Wernli KJ, White E, Chan AT, Hutter CM, Peters U, Newcomb PA. Common single nucleotide polymorphisms in the estrogen receptor beta promoter are associated with colorectal cancer survival in postmenopausal women. Cancer Res. 2013 Jan 15;73(2):767-75. doi: 10.1158/0008-5472.CAN-12-2484. Epub 2012 Nov 13. PubMed
Carlos RC, Buist DS, Wernli KJ, Swan JS. Patient-centered outcomes in imaging: quantifying value. J Am Coll Radiol. 2012;9(10):725-8. doi: 10.1016/j.jacr.2012.06.008. PubMed
Braithwaite D, Zhu W, Hubbard R, O'Meara ES, Miglioretti DL, Geller B, Dittus K, Wernli K, Moore D, Kerlikowske K, for the Breast Cancer Surveillance Consortium. Benefits and harms of screening mammography frequency by age and comorbidity score. Cancer Epidemiol Biomarkers Prev. 2012;21(3):565. Epub 2012 Feb 15. PubMed
Schur EA, Elmore JG, Onega T, Wernli KJ, Sickles E, Haneuse S. The impact of obesity on follow-up after an abnormal screening mammogram. Cancer Epidemiol Biomarkers Prev. 2012 Feb;21(2):327-36. Epub 2011 Dec 5. PubMed
Checkoway H, Ray RM, Lundin JI, Astrakianakis G, Seixas NS, Camp JE, Wernli KJ, Fitzgibbons ED, Li W, Feng Z, Gao DL, Thomas DB. Lung cancer and occupational exposures other than cotton dust and endotoxin among women textile workers in Shanghai, China. Occup Environ Med. 2011 Jun;68(6):425-9. doi: 10.1136/oem.2010.059519. Epub 2010 Dec 3. PubMed
Burnett-Hartman AN, Newcomb PA, Mandelson MT, Adams SV, Wernli KJ, Shadman M, Wurscher MA, Makar KW. Colorectal polyp type and the association with charred meat consumption, smoking, and microsomal epoxide hydrolase polymorphisms. Nutr Cancer. 2011;63(4):583-92. PubMed
Coghill AE, Newcomb PA, Chia VM, Zheng Y, Wernli KJ, Passarelli MN, Potter JD. Pre-diagnostic NSAID use but not hormone therapy is associated with improved colorectal cancer survival in women. Br J Cancer. 2011 Mar 1;104(5):763-8. Epub 2011 Feb 8. PubMed
Wernli KJ, Hampton JM, Trentham-Dietz A, Newcomb PA. Use of antidepressants and NSAIDs in relation to mortality in long-term breast cancer survivors. Pharmacoepidemiol Drug Saf. 2011;20(2):131-7. doi: 10.1002/pds.2064. PubMed
Wernli KJ, Newcomb PA, Wang Y, Makar KW, Shadman M, Chia VM, Burnett-Hartman A, Wurscher MA, Zheng Y, Mandelson MT. Body size, IGF and growth hormone polymorphisms, and colorectal adenomas and hyperplastic polyps. Growth Horm IGF Res. 2010;20(4):305-9. Epub 2010 May 26. 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