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The prevalence at death of carcinoma of the lung in miners and ex-miners has been compared in those with and without pneumoconiosis at necropsy. The prevalence of 11 .4u/% in the group as a whole is no greater than that in the male population in North-west England. Carcinoma of the lung was present in 62 (13-1%) of those without pneumoconiosis and in 52 (9 8%) of those with pneumoconiosis.The mean age at death of those with pneumoconiosis was 713 years so that they cannot be said to have died before the age at which they would have developed carcinoma. Those with progressive massive fibrosis whose mean age at death was 72 years had the lowest prevalence of carcinoma of the lung at all ages-8-4%.For reasons stated in the text this is inevitably a biased sample. The number of those without pneumoconiosis is probably lower than the true figure because the deaths of miners and ex-miners in whom there is no suspicion of lung disease may not have been reported to the coroner or to the pneumoconiosis medical panel.There appears to be no positive link between carcinoma of the lung and pneumoconiosis. There is a surprisingly high number of smokers and ex-smokers among these miners, and this appears to have more relevance to the prevalence of carcinoma of the lung than does pneumoconiosis.The purpose of this study was to investigate the prevalence at death of carcinoma of the lung in coalminers who have worked in the Lancashire coalfields and to relate this to pneumoconiosis by direct observation of the lungs at necropsy without reference to the cause of death as stated on the death certificate.Most investigations into the prevalence of carcinoma of the lung in coalminers have been based on information obtained from death certificates and occupational statistics. Heasman (1962) has shown that the cause of death as stated on death certificates may underestimate the prevalence of carcinoma of the lung by 15 to 20%. Liddell (1973) has shown the unreliability of occupational statistics in giving the correct occupational status of a miner, especially when he has done other work after leaving the mines. Kennaway and Kennaway (1953) and Goldman (1965)

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