[Lung neoplasms in the Berne region. Epidemiology and smoking habit, compared to histology].

223 lung cancer patients were observed from June 1974 to April 1976. The diagnosis was by histology (after biopsy, operation or autopsy). There were 125 (56%) squamous cell carcinomas (sqcc), 42 (19%) small cell carcinomas (smcc), 27 (12%) large cell carcinomas (lacc) and 29 (13%) adenocarcinomas (adec). There were only 6 women (2.7%) in the series (3adec, 2 smcc and 1 lacc). Heavy and very heavy smokers were common in each group; smoking habits--even of patients with adec - differed markedly (p less than 0.0005) from those of an age and sex matched control group of 90 asthmatic patients with atopy. Sqcc patients were evenly distributed over the rural and urban zones of our region. But smcc, lacc and adec were more often seen coming from urban zones (p less than 0.0025). The whole lung cancer group was divided into a small group of 6 non-smokers (2.7%), into a 6.7% group of 15 pipe smokers, into a large group of 69 cigar smokers (30.9%) and into a final group of 133 (59.6%) cigarette smokers. The cigar smokers usually had sqcc (p less than 0.0005). The cancer of cigar smokers is more often a central lesion than a peripheral one (p less than 0.025). A history of repeated airway infections on the one hand, and severe airway infection at the beginning of lung cancer history on the other, are a more frequent association in cigar smokers than in cigarette smokers (p less than 0.01). Therefore, the lung cancer of cigar smokers is especially difficult to recognize. Cigar smoking appears to be just as important a link in the chain of causative factors leading to lung cancer as cigarette smoking.