Treskova M, et al. – This trial sought to investigate the effects of the eligibility criteria and nodule management protocols on the benefits, harms and cost–effectiveness of lung screening situations, in Germany. The findings revealed that lung cancer screening could be cost–effective in Germany. The nodule management protocol affected the screening performance and cost–effectiveness, along with the eligibility criteria. Definition of the thresholds for nodule size and nodule growth in the nodule management protocol ought to be regarded comprehensively when defining optimal screening strategies.