Clinical evidence supporting intensive surveillance post cancer treatment is relatively lacking.Most studies show more intense surveillance regimens have minimal, if any, impact on survival, quality of life, or cost-effectiveness.
The lack of benefit of aggressive surveillance has been demonstrated in breast cancer, and is evolving in colon cancer calling into question the usefulness of such a technique.
Appropriate use of surveillance must account for the interval between examinations, duration of testing that are aligned with the maximal recurrence risk in natural tumor history, studies should be directed to the sites of recurrence and should have high protective values, therapies that may be available that could potentially cure or prolong life should be available, and the potential risk of secondary malignancy should be incorporated into considering clinical evaluations.
It is a tempting belief that surveillance for metastases can help patients, but there are significant possible harms: anxiety, costs, abnormal incidental findings, and procedural complications, exposure to potentially toxic effects of therapy at a time when patients would have been asymptomatic.
In some cases early detection of cancer recurrences may not influence therapy as in some instances treatment is not recommended for asymptomatic metastatic disease.
Research generally suggests that routine surveillance finds more recurrences leading to more surgery, chemotherapy, and radiation without affecting the risk of death: where the primary effect of surveillance is to give patients bad news sooner.