What’s the most common HPV-related malignancy in the US? Hint: it ain’t cervical cancer. That’s right, it’s oropharyngeal cancer. The incidence is growing at alarming rates, threatening the lives of otherwise healthy middle-age men everywhere. Why men? No one really knows how to explain the male to female ratio of 5 to 1, but researchers think it has a lot less to do with differences in sexual practices and a lot more to do with differences in underlying biology related to rates of acquisition and/or persistence of oral HPV infections. The bad news? There’s still no pap smear for the throat. The good news? There’s a potential cure for future generations, and it comes in the form of primary prevention. TBL: Both female and male patients have a lot to gain from the Gardasil vaccine, but verdict is still out on how a Y chromosome affects immunogenicity.