Louise C. Walter, MD
Assistant Professor, Department of Medicine (Geriatrics), UCSF
Cancer Center Program Memberships
Cancer ControlResearch Summary
Dr. Walter was appointed Chief of the UCSF Division of Geriatrics in July 2013 after serving as interim division chief since August 2012.
Dr. Walter is a clinician-researcher who is a national leader in evaluating the real-world risks and benefits of cancer screening in older patients. Dr. Walter received her MD from Stanford University in 1995. She completed a residency in internal medicine and a fellowship in geriatrics at UCSF. Dr. Walter joined the UCSF faculty in July 2001, and she is a geriatrician at the San Francisco VA Medical Center.
Dr. Walter has transformed our approach to cancer screening in older adults. She has developed novel methodology demonstrating the fundamental importance of life expectancy rather than age in determining benefits and risks of screening. Virtually every cancer screening guideline cites her research. Further, her studies of older adults in poor health documented the extent to which screening can lead to clinical harm. Her approach also forms the basis for the management of other chronic diseases (e.g., diabetes) in older adults.
In addition, Dr. Walter led a series of seminal studies demonstrating decisions to screen older adults for cancer are often dictated more by age than health such that many patients in poor health continue to undergo screening while many healthy older patients fail to get screened. Also, she discovered that cancer screening frequently leads to significant harms without benefit in patients in poor health and developed a taxonomy and quantification of screening harms. This research changed national VA quality indicators and convinced California state auditors to abandon their mandatory mammography policy for health plans that care for frail elders.
Dr. Walter is Principal Investigator of a $2.5 million Geriatric Workforce Enhancement Program grant from HRSA and Principal Investigator of a K24 mentoring award from the National Institute on Aging. Dr. Walter is strongly committed to mentoring the next generation of clinical investigators as evidenced by her receipt of the 2010 UCSF Academic Senate Distinction in Mentoring Award (given annually to one Associate Professor who provides exceptional mentoring) and her receipt of the Society of General Internal Medicine's Research Mentor of the Year Award in 2013.
Dr. Walter is the Associate Director of the UCSF Clinical and Translational Science Institute Career Development (KL2) Program and Director of the San Francisco VA’s Health Services Research and Development Program to Improve Care for Veterans with Complex Comorbid Conditions. She also is the Core Leader of the Research Career Development Core (RCDC) for the UCSF Pepper Center for Aging Research.
Education
Stanford University, Stanford, CA, B.S., 1990, Biology
Stanford University School of Medicine, Stanford, CA, M.D., 1995, Internal Medicine
University of California, San Francisco (Advanced Training in Clinical Research Program), Certificate, 1999, Clinical Epidemiology
Professional Experience
-
1989-1990
Research Assistant, Department of Nuclear Medicine, Stanford University School of Medicine -
1992-1993
Research Assistant, Department of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine -
1995-1998
Medical Resident, University of California, San Francisco -
1998-2001
Fellow in Geriatrics, University of California, San Francisco -
2001-present
Staff Physician, San Francisco Veterans Affairs Medical Center -
2001-present
Assistant Professor of Medicine, Geriatrics Division, University of California, San Francisco
Honors & Awards
- 1990
Phi Beta Kappa, Stanford University - 1990
Scholastic Honors with Distinction, Stanford University - 1995
Dean's Award for Outstanding Community Service, Stanford University School of Medicine - 1995
Dean's Award for Outstanding Teaching, Stanford University School of Medicine - 1999
Hartford/AFAR Pilot Grant: "Outcomes of Screening Mammography in Frail Elderly Women." - 1999
Journal of General Internal Medicine, top 10% of reviewers - 2002
VA Career Development Award in Health Services Research and Development
Selected Publications
- Torres JM, Rudolph KE, Sofrygin O, Wong R, Walter LC, Glymour MM. Having an Adult Child in the United States, Physical Functioning, and Unmet Needs for Care Among Older Mexican Adults. Epidemiology. 2019 Jul; 30(4):553-560.
View on PubMed - Kotwal AA, Walter LC, Lee SJ, Dale W. Are We Choosing Wisely? Older Adults' Cancer Screening Intentions and Recalled Discussions with Physicians About Stopping. J Gen Intern Med. 2019 May 30.
View on PubMed - Wray CM, Vali M, Walter LC, Lopez L, Austin PC, Byers A, Keyhani S. Examining the Utility of 30-day Readmission Rates and Hospital Profiling in the Veterans Health Administration. J Hosp Med. 2019 May; 14(5):266-271.
View on PubMed - Conway M, Keyhani S, Christensen L, South BR, Vali M, Walter LC, Mowery DL, Abdelrahman S, Chapman WW. Moonstone: a novel natural language processing system for inferring social risk from clinical narratives. J Biomed Semantics. 2019 Apr 11; 10(1):6.
View on PubMed - Washington SL, Porten SP, Quanstrom K, Jin C, Bridge M, Finlayson E, Walter LC, Suskind AM. The Association Between Race and Frailty in Older Adults Presenting to a Nononcologic Urology Practice. Urology. 2019 May; 127:19-23.
View on PubMed - Dotan E, Walter LC. The NCCN Older Adult Oncology Panel Remembers Arti Hurria. J Natl Compr Canc Netw. 2019 Feb 01; 17(2):e1-e2.
View on PubMed - Carpenter CR, Hurria A, Lundebjerg NE, Walter LC, Mody L. Leadership Lessons: Developing Mentoring Infrastructure for GEMSSTAR Scholars. J Am Geriatr Soc. 2019 Apr; 67(4):650-656.
View on PubMed - Wray CM, Vali M, Abraham A, Zhang A, Walter LC, Keyhani S. Validation of Administrative Measures of Social and Behavioral Risk in Veterans Affairs Medical Records. J Gen Intern Med. 2019 Jan 02.
View on PubMed - Gibson CJ, Lisha NE, Walter LC, Huang AJ. Interpersonal trauma and aging-related genitourinary dysfunction in a national sample of older women. Am J Obstet Gynecol. 2019 Jan; 220(1):94.e1-94.e7.
View on PubMed - Wong ML, McMurry TL, Schumacher JR, Hu CY, Stukenborg GJ, Francescatti AB, Greenberg CC, Chang GJ, McKellar DP, Walter LC, Kozower BD. Comorbidity Assessment in the National Cancer Database for Patients With Surgically Resected Breast, Colorectal, or Lung Cancer (AFT-01, -02, -03). J Oncol Pract. 2018 Oct; 14(10):e631-e643.
View on PubMed - Tang V, Zhao S, Boscardin J, Sudore R, Covinsky K, Walter LC, Esserman L, Mukhtar R, Finlayson E. Functional Status and Survival After Breast Cancer Surgery in Nursing Home Residents. JAMA Surg. 2018 Aug 29.
View on PubMed - Wong ML, Paul SM, Mastick J, Ritchie C, Steinman MA, Walter LC, Miaskowski C. Characteristics Associated With Physical Function Trajectories in Older Adults With Cancer During Chemotherapy. J Pain Symptom Manage. 2018 Nov; 56(5):678-688.e1.
View on PubMed - Wong ML, Shi Y, Fung KZ, Ngo S, Elicker BM, Brown JK, Hiatt RA, Tang VL, Walter LC. Age, comorbidity, life expectancy, and pulmonary nodule follow-up in older veterans. PLoS One. 2018; 13(7):e0200496.
View on PubMed - Yang E, Lisha NE, Walter L, Obedin-Maliver J, Huang AJ. Urinary Incontinence in a National Cohort of Older Women: Implications for Caregiving and Care Dependence. J Womens Health (Larchmt). 2018 09; 27(9):1097-1103.
View on PubMed - Wolf AMD, Fontham ETH, Church TR, Flowers CR, Guerra CE, LaMonte SJ, Etzioni R, McKenna MT, Oeffinger KC, Shih YT, Walter LC, Andrews KS, Brawley OW, Brooks D, Fedewa SA, Manassaram-Baptiste D, Siegel RL, Wender RC, Smith RA. Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society. CA Cancer J Clin. 2018 07; 68(4):250-281.
View on PubMed - Shi Y, Fung KZ, John Boscardin W, Ngo S, Freedland SJ, Wong ML, Walter LC. Individualizing PSA Monitoring Among Older Prostate Cancer Survivors. J Gen Intern Med. 2018 05; 33(5):602-604.
View on PubMed - Braithwaite D, Miglioretti DL, Zhu W, Demb J, Trentham-Dietz A, Sprague B, Tice JA, Onega T, Henderson LM, Buist DSM, Ziv E, Walter LC, Kerlikowske K. Family History and Breast Cancer Risk Among Older Women in the Breast Cancer Surveillance Consortium Cohort. JAMA Intern Med. 2018 Apr 01; 178(4):494-501.
View on PubMed - Suskind AM, Zhao S, Walter LC, Boscardin WJ, Finlayson E. Mortality and Functional Outcomes After Minor Urological Surgery in Nursing Home Residents: A National Study. J Am Geriatr Soc. 2018 May; 66(5):909-915.
View on PubMed - Partin MR, Gravely AA, Burgess JF, Haggstrom DA, Lillie SE, Nelson DB, Nugent SM, Shaukat A, Sultan S, Walter LC, Burgess DJ. Contribution of patient, physician, and environmental factors to demographic and health variation in colonoscopy follow-up for abnormal colorectal cancer screening test results. Cancer. 2017 Sep 15; 123(18):3502-3512.
View on PubMed - Suskind AM, Quanstrom K, Zhao S, Bridge M, Walter LC, Neuhaus J, Finlayson E. Overactive Bladder Is Strongly Associated With Frailty in Older Individuals. Urology. 2017 08; 106:26-31.
View on PubMed