Specializing in hepatology and GI, Dr. Banks-Blair cares for patients in College Park and three other locations in Maryland. Focusing on drug-induced liver injury, Dr. Banks-Blair was a medical officer at the FDA and she was the last of the Hyman Zimmerman Fellows. So she serves a diverse patient population that includes insured, uninsured, and underinsured patients. In addition to caring for her everyday patients, Dr. Banks-Blair has been a principal investigator on several multi-center hepatology and GI trials, including on Cologuard and Oroquick, and she has a medical degree from Howard University College of Medicine. Welcome, Dr. Banks-Blair. All righty. First, I want to thank you for having such a wonderful conference today. This is a topic that's well overdue, but it's not like it was delayed or it wasn't addressed because we have all been very busy doing a lot of work, and only time has shown that this needed to happen. So this is the right time to do it, and I truly believe these are the right people. I've learned a lot today, a lot of dynamics. You know, there are a lot of things we do that are similar, yet a little things that are a little bit different, but everybody cares. So I'm very optimistic that this is not just another conference. All right. So let's get started. My name is Alpha Banks-Blair. My husband wants me to emphasize the Blair because I usually don't mention that my last name is Blair, but I'm happily married. I started Banks Hepatology Institute about 21 years ago, and that was not my goal. When I trained, I trained to be in a university. I did liver down in Miami. You know, it was a very dynamic program, GI Georgetown. So I was really trained to be in a hospital setting. But what drove me into the community was that I saw so many people who were baffled when they learned they had stage four, something that was really bad. So I made a decision to go out there to try to have those conversations with them when they were stage zero, stage one, because I really believe that it's very important to before the problem develops to start thinking about it. The College Park Surgery Center is an endoscopy unit that I opened 12 years ago. It still baffles me that I own a surgery center by myself, and it doesn't make sense. But it does make sense from the standpoint that I don't do this by myself. I have a wonderful staff. My staff members are the little people out of the neighborhoods. These are people who work very hard, long hours. They care. They live in these neighborhoods. They bring their families. They bring their friends. They bring their church members with them. The surgery center developed because hospitalized patients, as we are learning and seeing, are not the same people who need to go to an ASC. So we could see that there was a difference. So I thought that we were fighting over endoscopy time, but this was simply just a different patient with a different set of needs. So in my talk today, I'm going to give you a lot of numbers about the state of Maryland. I'm very proud to live there. I think our Department of Health has done a fantastic job planning for us. It is not unusual for them to constantly send out a lot of texts, actually emails, phone calls about very proactive events that are happening to maintain our health. So since we're talking colorectal cancer, in the state of Maryland, in 2019, there were 2,608 new cases of colorectal cancer. And putting that in perspective, in the state of Maryland, cancer of the colon is the number two cancer-related deaths in our state. The age-adjusted colorectal rate is really very similar to the national rate, and statistically there was no difference. In 2015 to 2019, our colorectal cancer incidence rates slightly increased by 0.2% per year. Now if we look at those patients who we identified, the 2,608, this gives information as far as staging. And I want to point out that there is a misstatement there. The third bullet should be distant mets. So you can see what our patient population was, 28.4% was local, 39.4 was regional, 21% was distant. And reported to our cancer registry was 11.2 that was unstaged. Going a little bit further in the screening, in 2020, I was very happy to hear these numbers at the roundtable that was held in Maryland, almost in Baltimore, in Annapolis. I sometimes forget that Baltimore is not the capital. But in any case, we are saying that we are up to date here. If you're looking at a target goal of maybe 80%, Maryland in 2020 could say that people who were 50 and older, 76.6% of them were up to date with their screening. That's a very good number. So I'll let that sink in. If you want to move to Maryland, we'll take care of you. According to the CRSC, the colorectal cancer program that we have there, that is cancer prevention that is focused on education, screening, and treatment. That came about in the year 2000 when Maryland took the tobacco funds and looked at all of the counties, looked across the state, and identified which of those counties, we have 24, plus Baltimore being treated as though it is a different county. But we have 24 jurisdictions. And those jurisdictions identified what their needs were. The goal was to maintain the health of Marylanders. It was to decrease the colon cancer rate and decrease cancer-related mortality. With those tobacco funds, Maryland decided to break it out over seven cancers. One of those seven is colorectal. And with screening that was done through the funds from that particular program, in the year 2022, there were 1,479 persons who were screened. Now, remember, this is during the pandemic. And during that year in 2022, 13 of those persons who were screened had colorectal cancer. If you look at the year 2023, which is where we are now, there have been 1,590 persons screened, and thus far, 25 of those had colorectal cancer. I don't have the breakout as far as what the staging is on those patients. I'm almost out of slides, too. So we'll be back on target. In 2022, there were pilot program clinics. These clinics were very similar to what I heard some of the speakers today say, that those are the aspirational goals of having patient navigators. We have those in the state of Maryland. We have systems of where if a patient is underinsured or uninsured, they can apply. And there's a process. The different counties have very well put together websites. They have persons who will help the patients. And on the websites, it identifies what type of documentation that that person would need to establish that they really do meet the criteria. So for example, the finances, you have to establish that you're in a county, that you are really a resident of that particular county. So when you look at the fact that 23 out of 24 of those counties have a place, every Marylander really has no reason not to be screened. And what was observed was that when they looked at fit test kits return, the baseline began at 31%, and in 2022, it was 77%. When you look at colonoscopy completion rate, it used to be 12%, now it's 53%. So there's clearly improvement there. I am humbled by what we've talked about today. We've got a lot of work to do, and I think it requires everybody being willing to change your mind. The experiences in each jurisdiction is very different, but the patient is the same. Thank you.

hepatologist

drug-induced liver injury

gastrointestinal disorders

Maryland

clinical practice