Objective: To evaluate the importance of the sex and the influence of tobacco on the etiology of patients with hemoptysis.

Methods: We analyzed and compared the etiology of 394 consecutive patients with hemoptysis, divided in two groups: I (males) and II (females), and stratified in relation to tobacco.

Results: 305 males (77.4%) and 89 females (p < 0.0001). Lung cancer was more frequent in both groups (26.9%), especially squamous cell carcinoma, but nonmalignant etiologies were more common when we considered all globally (73.1%), including chronic obstructive lung disease (COPD) (14.9%) or bronchiectasis (20.4%) as the more frequent diseases, and 14.2% of unknown etiology (5.2% if we excluded bronchitis or lung infections). Lung tuberculosis was decreased (1.5%) in relation to a increased frequency of its sequelaes or residual lesions (10%). The initial increased frequency of lung cancers or COPD in males and bronchiectasis or heart diseases in females disappeared after the stratification and elimination of the tobacco effect.

Conclusions: Hemoptysis was more frequent in males and nonmalignant etiologies were more common in both groups, with similar rates as in previous literature and a low number of cases with a unknown etiology associated to a protocolized study and the increased use of diagnostic procedures. In our study, the etiology of patients with hemoptysis was sex independent, to show that the susceptibility to tobacco illness was similar in both sexes.

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