To find subtle changes, use the oldest previous, not the most recent previous for comparison. Check your PACS settings and change them if necessary. Cancers generally (but not always) change with time. Use this fact to best advantage by comparing with the oldest study you have.

If you are reading digital images, use the oldest digital images. If you read analog, use the oldest analog images. If you are comparing digital with analog, good luck.

If you look at oldest and newest, the lesion jumps out at you. If you glance oldest and 2 year prior you may let the change slip by. Read your screening studies in batches in an uninterrupted phoneless environment.