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Louise Walter, M.D.
Professor in Residence, Geriatrics
University of California, San Francisco School of Medicine
louise.walter@ucsf.edu
2006-2009 Cohort
Project title: "Targeting of Colorectal Cancer Screening to Healthy Elders"





About the Project:

Dr. Walter conducted a cohort study of 27,068 screen-eligible VA patients 70 years or older to evaluate whether colorectal cancer screening is targeted to healthy older patients and is avoided in older patients with severe comorbidity who have limited life expectancies.  She found that only 47% of patients with no comorbidity (5-year mortality rate=19%) were screened, whereas 41% with severe comorbidity (5-year mortality rate=55%) were screened.  This indicates that colorectal cancer screening is not being appropriately targeted to healthier patients.

Biosketch:

Louise C. Walter, M.D. is currently an Professor in Residence in Geriatrics at UCSF, and has been a staff physician at the San Francisco VA since 2001. Dr. Walter completed her undergraduate work in Biology at Stanford University in 1990 and completed her medical training at Stanford University School of Medicine in 1995. She went to the University of California, San Francisco (UCSF) for residency in internal medicine, which she completed in 1998, and remained at UCSF for her geriatrics research fellowship, which she completed in 2001.

Dr. Walter's major research interest is cancer screening in older persons. In her earlier work she developed a conceptual framework to guide cancer screening decisions in older persons in a more sensible way than the conventional use of age cutoff guidelines, which has been the focus of her VA HSR&D Career Development Award. Her approach involves estimates of life expectancy, risk of cancer death, screening outcomes, and discussion of patient preferences. This framework forms the basis for much of her ongoing research, which is currently focused on how health status affects the use and outcomes of colorectal cancer screening in older persons.

The title of her Physician Faculty Scholars Program research project was "Targeting of Colorectal Cancer Screening to Healthy Elders," which aimed to help clinicians increase rates of cancer screening in healthy older persons who may benefit from screening, while avoiding screening in elders in whom the harms of screening exceed the benefits.


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