Women in England are not showing up for their annual pap tests. And their absence from this critical screening opportunity is increasing their risk of cervical cancer -- a cancer that is curable if detected early.

New figures reveal that 660,000 women between the ages of 25 and 29 are invited for screening in England. Nearly 80 percent of these women accepted their invitations and reported for their tests in 1995 -- but only 69.4 percent did so last year. Women aged 30 to 34 are also down in attendance -- by about 800 women per week. Essentially, this means about 2,000 women each year who have pre-cancerous cells are missing the chance for early detection and diagnosis.

The Department of Health, now investigating the falling figures, attributes the decline to perhaps a not-so-successful screening program, discomfort about the procedure, or fear that the experience will be embarrassing.

He an unlikely breast cancer survivor -- because he is a man. But still he developed the disease that roughly 1,700 men will contract this year. And while that statistics pertaining to women and men with breast cancer differ -- women are 100 times more likely to get the disease -- the biology of the disease is exactly the same. Under the microscope, breast cancer is breast cancer. It does not behave any differently in female and male bodies. And detection, treatment, and survival rates are nearly identical for both sexes.

Bob Riter, 49, was diagnosed with breast cancer in 1996. Now in remission, he works as the associate director of the Ithaca Breast Cancer Alliance in New York where he speaks out and educates the public about this widespread disease. He believes his personal story, with its different twist, prompts people to really listen.

Riter's audiences learn that breast cancer in men usually presents itself as a lump in the chest, dimpling of the skin, or changes in the nipple. Doctors can perform breast exams, mammography, and biopsy to investigate the possibility of the cancer that typically strikes men between the ages of 60 and 70. Treatment includes mastectomy to remove the tumor and surrounding lymph nodes, chemotherapy, radiation, and hormone therapy.

It was the presence of blood coming from his nipple that sent Riter to his doctor -- and then to a surgeon who declared a diagnosis of breast cancer. Riter is somewhat of an exception because he reported to his doctor immediately. Most men do not. Many do not even realize they are at risk of breast cancer so they ignore symptoms. They also may go underground with their suspicions of breast cancer because of embarrassment. Both can lead to diagnoses of more advanced diseases.

Riter is doing his part to enlighten both men and women that men are not immune to breast cancer, that they should be active in monitoring their breast health. "I really like to go to national breast cancer meetings," he says, "because a lot of people know that men get breast cancer in theory, but until you have a face to associate with it, it's fairly abstract. And so I'm sort of that face."

Testicular cancer, cancer in one or both of the testicles, usually occurs in young men and will strike about 8,250 of these men this year. About 370 men will die.

A man's lifetime risk of developing this cancer -- that typically shows up in only one testicle -- is 1 in 300, securing it as one of the less common cancers in the United States. The chances of dying from testicular cancer are 1 in 5,000, making it one of the most curable forms of cancer. Yet it is still the most common form of cancer in men ages 15-34. It is also a cancer commonly characterized by denial and embarrassment. As a result, it is one of the least mentioned cancers.

Coletta Barrett believed her stomach pains were caused by a gall bladder attack after eating greasy fried food. She excused a tightening in her lower abdomen as irritable bowel syndrome, and she explained blood in her stool as a response to stress. Only after a referral to a gastroenterologist led to a colonoscopy did she learn that the upper portion of her colon was almost completely blocked by a large tumor -- a cancerous tumor. Barrett was diagnosed with colon cancer. Her colonoscopy saved her life.

Barrett never once predicted she might have colon cancer. She thought the disease mostly struck older people. She was just 42. Screening tests are not even recommended until the age of 50. She had no family history of this cancer and had no typical risk factors associated with the disease. She did not smoke, was not overweight, and drank very little. But she did in fact have colon cancer -- shocking as it was -- and doctors believed her tumor had been growing for 18 months before detected. Fortunately, Barrett learned that her cancer had not spread. And she learned a few other things that she now shares as advice -- from her survivor point of view. These tips come from an article about Barrett in the August 1 Women's Day magazine.

• Barrett says, "know your body." And don't ignore or dismiss any changes that occur.
• Don't let embarrassment stop you from seeking help. Some symptoms can be difficult to discuss -- such as change in size and frequency of bowel movements, bloody stool, cramping, and bloating -- but still ask your doctor about them. Early detection is critical, she says.
• If diagnosed with colon cancer, learn as much as you can about the disease -- a well-informed patient has a better chance at a better outcome.

Barrett offers sound advice. And I think it is global advice. Knowing your body, discussing symptoms, and education after diagnosis are key for anyone. For everyone.