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, Wernli KJ, Anton-Culver H, Engstrom P, Greenberg ER, Meyskens F. Opportunities for cancer epidemiology and control in low- and middle-income countries: a report from the American Society for Preventive Oncology international cancer prevention interest group. Cancer Epidemiol Biomarkers Prev. 2010 Jul;19(7):1665-7.
Astrakianakis G, Seixas NS, Ray R, Camp JE, Gao DL, Feng Z, Li W, Wernli KJ, Fitzgibbons ED, Thomas DB, Checkoway H. Re: Lung cancer risk among female textile workers exposed to endotoxin. J Natl Cancer Inst. 2010;102(12):913-4. Epub 2010 May 5. PubMed
Wong EY, Ray RM, Gao DL, Wernli KJ, Li W, Fitzgibbons ED, Camp JE, Heagerty P, Thomas DB, Checkoway H. Physical activity, physical exertion, and spontaneous abortion risk in women textile workers in Shanghai, China. Am J Ind Med 2010;53(5):497-505.
Newcomb PA, Wernli KJ Risk factors. In Breast Cancer Risk Reduction and Early Detection Strategies. Edited by E. Sauter and M. Daly. Springer. New York City, 2010, pages 3-22.
Wernli KJ, Aiello Bowles EJ, Haneuse S, Elmore JG, Buist DS. Timing of follow-up after abnormal screening and diagnostic mammograms. Am J Manag Care. 2011 Feb;17(2):162-7.
Buist DM, Ichikawa L, Wernli KJ, Lee CI, Henderson LM, Kerlikowske K, Bowles EJ, Miglioretti DL, Specht J, Rauscher G, Sprague B, Onega T, Lee JM. Facility variability in examination indication among women with prior breast cancer: implications and the need for standardization. J Am Coll Radiol. 2020 Jan 28. pii: S1546-1440(19)31483-8. doi: 10.1016/j.jacr.2019.12.020. [Epub ahead of print]. 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