The study aimed to evaluate the impact of a cloud-based CT interpretation system equipped with semi-automated measurement and computer-aided detection (CAD) for lung nodules on a nationwide lung cancer screening program. The program initially relied on each institution's interpretation systems and manual nodule measurement. The cloud-based system, implemented by Coreline Soft using AVIEW LCS, was later introduced. Results showed that while the number of detected nodules significantly increased with the cloud-based system, the positive rate didn't significantly differ from the conventional system. However, the variability of positive rates across institutions significantly reduced with the cloud-based system. In terms of sensitivity and specificity based on Lung-RADS version 1.0, no significant difference was observed between the two systems. The findings suggest that CAD and semi-automated measurements can enhance nodule detection and reduce variability in positive rates across different institutions in a nationwide lung cancer screening program.