**8. Acknowledgment**

384 Cancer Prevention – From Mechanisms to Translational Benefits

education efforts.19 It is also a good idea to incorporate health communication training for both health care providers (educators) and consumers to enhance the quality of cross-

Strategic communication efforts can promote cancer prevention and control for at-risk populations. To achieve these goals efforts must be taken to develop evidence-based communication campaigns to increase awareness about prevention. These campaigns must be designed to persuade members of at-risk groups to adopt prevention recommendations, change negative health habits, and adopt healthy lifestyles. Communication campaigns should be designed not only to initiate these healthy behavior changes, but to also reinforce and sustain behavior changes over time. Campaigns should be designed to increase awareness about the importance of developing healthy lifestyles and engaging in regular recommended cancer screening and early detection activities. Efforts should be taken to implement and promote easily accessible and affordable screening programs. Screening practices should be monitored to refine and improve screening programs and promotion

Several lessons have been learned from past efforts to increase the effectiveness of cancer communication interventions with vulnerable populations.20,29,26 These lessons include the

Gathering full audience and needs information to guide health communication

Involving and empowering vulnerable and at-risk consumers in health communication

Designing culturally appropriate messages and materials for communication

Focusing on the family and the community for delivering and reinforcing messages,

Evaluating the influences of communication interventions to refine and improve

The development and implementation of strategic health communication interventions holds great promise for promoting cancer prevention and control for vulnerable populations. By investing in the development of strategic cancer communication efforts we can develop an infrastructure for disseminating relevant cancer information. We can test new strategies, models, and tools for designing effective strategic communication interventions to reduce cancer-related health disparities. We can also encourage the

 Testing message and channel strategies to refine communication activities. Using close, familiar, and frequently used communication channels. Developing vivid, engaging, and moving messages for interventions.

 Developing inter-organizational partnerships to support intervention efforts; Providing appropriate training and support for both consumers and providers;

Providing consumers with choices and options for promoting their health.

adoption of best practices for cancer prevention and control.

cultural communication efforts.20,51

activities.

**7. Conclusion** 

importance of:

efforts.

efforts;

efforts;

efforts.

and;

I acknowledge the support of my current colleagues at George Mason University's Center for Health and Risk Communication and my former colleagues in the Health Communication and Informatics Research Branch at the National Cancer Institute for their input and encouragement in helping me refine the ideas presented in this chapter.

## **9. References**


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**15** 

*USA* 

**Early Detection: An Opportunity for Cancer** 

Cancer is the second leading disease cause of death in the United States. A group of more than 100 different and distinctive diseases, cancer may involve any tissue of the body. Estimates are that there were over 1.5 million cases in 2010 in the United States alone. Only a small fraction (less than 20%) of cancers are diagnosed at a localized stage where curative therapy is effective. Most cancers are diagnosed only after the primary tumor has already metastasized so that chemotherapy is required for treatment. Hence, early detection is a favored opportunity to reduce cancer mortality. By detecting cancer in its very earliest stages when perhaps only a small number of cells are present, it is possible that early intervention will be effective in preventing further development of the incipient cancer

Despite advances in early detection of major forms of human cancer (prostate, breast, lung, colon, leukemia, lymphoma), more often than not, cancers have developed to a sufficiently late stage at the time of detection to preclude most opportunities for curative therapy (Altekruse et al., 2010). The problem is exacerbated for pancreatic cancer where clinical symptoms invariably are delayed until the disease state is well advanced beyond metastatic spread. A need for early detection remains as one of the most important challenges at the

Ecto-Nicotinamide Adenine Dinucleotide Oxidase Disulfide-Thiol Exchanger 2 (ENOX2) (GenBank accession no. AF207881; Chueh et al., 2002) also known as Tumor-Associated Nicotinamide Adenine Dinucleotide Oxidase (tNOX) is ideally suited as a target for early diagnosis of cancer as well as for early preventive intervention (Fig. 1). The proteins are expressed on the cell surface of malignancies and detectable in the serum of patients with cancer (Cho et al., 2002). ENOX2 proteins are terminal hydroquinone oxidases of plasma membrane electron transport. From the standpoint of early intervention, they are important in the growth and enlargement of tumor cells (Morré and Morré, 2003a; Tang et al., 2007, 2008). Our approach using ENOX2, as a target for both early detection and for early interventions, is based on these properties (Cho et al., 2002; Morré and Morré, 2003a;

thereby resulting in what might be viewed as curative prevention.

forefront of cancer research, treatment and prevention.

**1. Introduction** 

**2. Approach** 

**2.1 Early detection** 

**Prevention Through Early Intervention** 

D. James Morré and Dorothy M. Morré

*MorNutech, Inc. West Lafayette, IN,* 

