Maldonado SG, Motsch E, Trotter A, et al. - Among 4,052 long‐term smokers (2,622 men), 50.3 to 71.9 years of age from the general population around Heidelberg, Germany, a randomized trial (German Lung Screening Intervention Trial) was conducted to compare five yearly rounds of low‐dose computed tomography (n = 2,029) with a control arm without intervention (n = 2,023), given that overdiagnosis is a major potential harm of lung cancer screening. A diagnosis of lung cancer was received by 74 participants in the control arm and 90 in the screening arm, following a median follow‐up of 9.77 years after randomization and 5.73 years since last screening. As per the estimates based on modeling, approximately 48% of screen‐identified tumors had a lead time ≥ 4 years, while nearly 33% had a lead time ≥ 6 years, 23% ≥ 8 years, 16% ≥ 10 years and 11% ≥ 12 years. In this study, a major risk of overdiagnosis for persons with comparatively short remaining life expectancies was shown to be suggested by the high proportions of tumors with relatively long lead times.