Objective:European lung cancer screening studies using computed tomography (CT) have shown that a management protocol based on measuring lung nodule volume and volume doubling time (VDT) is more specific for early lung cancer detection than a diameter-based protocol.However,whether this also applies to a Chinese population is unclear.The aim of this study is to compare the diagnostic performance of a volume-based protocol with a diameter-based protocol for lung cancer detection and optimize the nodule management criteria for a Chinese population.Methods:This study has a population-based,prospective cohort design and includes 4000 participants from the Hexi district of Tianjin,China.Participants will undergo low-dose chest CT at baseline and after 1 year.Initially,detected lung nodules will be evaluated for diameter and managed according to a routine diameter-based protocol (Clinical Practice Guideline in Oncology for Lung Cancer Screening,Version 2.2018).Subsequently,lung nodules will be evaluated for volume and management will be simulated according to a volume-based protocol and VDT (a European lung nodule management protocol).Participants will be followed up for 4 years to evaluate lung cancer incidence and mortality.The primary outcome is the diagnostic performance of the European volume-based protocol compared to diameter-based management regarding lung nodules detected using low-dose CT.Results:The diagnostic performance of volume-and diameter-based management for lung nodules in a Chinese population will be estimated and compared.Conclusions:Through the study,we expect to improve the management of lung nodules and early detection of lung cancer in Chinese populations.