In the NELSON study, nodule management that was based on growth-rate assessment for intermediate nodules was shown to increase the sensitivity of lung cancer detection.2 Such pulmonary nodule management was implemented in France during the course of our trial.3 Compared with the NELSON screening programme, chest CT scans in the IFCT-0302 trial were standard dosed, and done more frequently, which might have counterbalanced the potential loss in sensitivity for the detection of small pulmonary nodules. ...as emphasised by Goto, in our study, CT-based follow-up enabled the detection of more cases of early recurrence and second primary lung cancer than the minimal follow-up group, and they were more frequently treated with curative intent. Whether a trial implementing a personalised follow-up strategy and using a more up-to-date nodule management could translate into survival benefit remains unknown.