Prospective Multicenter Cohort Study to Validate Four Groups of Biomarkers for Assessing Lung Cancer Risk Among Patients With Atheromatous Cardiovascular Disease in a Screening Pathway

Interventional study with minimal risks and constraints, with evaluation of the incidence of lung cancers by low-dose thoracic CT scan without injection of contrast medium, of the immunological, inflammatory and metabolic blood profile and of the microbiota; systematic proposal of smoking cessation for active smokers or assistance in maintaining cessation.

Inclusion Criteria: * 1- All PREVALUNG or PREVALUNG ETOILE participants * 2- Active or former smokers who have smoked daily for at least 10 years and have either atheromatous disease (coronary, lower limb, supra-aortic trunk, aortic, visceral or upper limb arteries) or a moderate or high coronary calcium score\*, \*\*. Inclusion criteria: * Age 45- 75 years and * Medical follow-up for smoking-related atheromatous pathology and * daily smoking for at least 10 years prior to disease (for smoking, there are no quantitative criteria or withdrawal times) * visual coronary calcium score quantified by a radiologist on a chest CT scan. 3- Individuals at risk of lung cancer without atheromatous disease or moderate or high calcium score being managed for a tobacco-related disease (chronic bronchitis or non-progressive cancer \> 5 years) or with eligibility criteria for lung cancer screening (inclusion criteria in the NLST or NELSON studies or American recommendations)\*\*. Inclusion criteria : * Age 45- 75 and * Medical follow-up for a smoking-related pathology: * chronic obstructive pulmonary disease / emphysema, or * history of non-progressive cancer \> 5 years, including ENT, lung, breast, cervix, excreto-urinary tract, bladder, esophagus, stomach, pancreas, liver, kidney, chronic myeloid leukemia. and \- daily smoking for at least 10 years prior to the disease (for smoking, there are no quantitative criteria or withdrawal periods). Or Inclusion criteria in NLST : * Age 55 - 74 * Cumulative smoking ≥ 30 pack-years * active or weaned for less than 15 years Or NELSON inclusion criteria : * Age 50-75 * Smoking : * \> 15 cigarettes /D for more than 25 years or * \> 10 cigarettes /D for more than 30 years * active smoking or cessation \< 10 years Or American recommendations : * Age 50 - 80 * Smoking ≥20 PA Exclusion Criteria: * cancer history \< 5 years (except carcinoma in situ of the uterine cervix, basal cell carcinoma of the skin, non-invasive urothelial carcinoma treated for curative purposes without CT lung surveillance, prostate cancer with unmeasurable PSA) * symptoms of lung cancer (involuntary weight loss \> 7 kg in 1 year, hemoptysis) * known history of pulmonary nodule requiring specialized follow-up * history of pulmonary fibrosis or pulmonary hypertension * active pulmonary parenchymal infection * severe cardiac or respiratory insufficiency (rest dyspnea) * performance status (WHO) 2, 3 or 4 * patient not affiliated to the social security system (beneficiary or beneficiary's beneficiary) * patient deprived of liberty * patients under guardianship or trusteeship * pregnant or breast-feeding women