In this paper, we present a computer-aided diagnosis (CAD) system to automatically detect lung cancer candidates at an early stage using a present and a past helical CT screening. We have developed a slice matching algorithm that can automatically match the slice images of a past CT scan to those of a present CT scan in order to detect changes in the lung fields over time. The slice matching algorithm consists of two main process: the process of extraction of the lungs, heart, and descending aorta and the process of matching slices of the present and past CT images using the information of the lungs, heart, and descending aorta. To evaluate the performance of this algorithm, we applied it to 50 subjects (total of 150 scans) screened between 1993 and 1998. From these scans, we selected 100 pairs for evaluation (each pair consisted of scans for the same subject). The algorithm correctly matched 88 out of the 100 pairs. The slice images for the present and past CT scans are displayed in parallel on the CRT monitor. Feature measurements of the suspicious regions are shown on the relevant images to facilitate identification of changes in size, shape, and intensity. The experimental results indicate that the CAD system can be effectively used in clinical practice to increase the speed and accuracy of routine diagnosis.