What is the best frequency of follow up visits for patients treated for localized skin melanoma?

This paper evaluated the proper frequency of follow up visits for patients treated for localized (stage I or II) melanoma.  

Stage I and II melanomas are localized (confined) to the skin. Patients with stage I or II melanoma are generally treated with a wide excision (surgery to remove the melanoma as well as a margin of normal skin around it). However, patients with a history of one melanoma are at increased risk of developing recurrences (return of the cancer) or a second primary melanoma (a new melanoma that develops after treatment of the first melanoma and does not originate from it). Therefore, patients that have been treated for melanoma need to be closely monitored by periodic visits to their doctor, imaging tests (chest x-rays, CT scans) and blood tests.

• according to the 2008 Australian and New Zealand guidelines involving follow-up every 6 months for 5 years, then annually for another 5 years (patients with stages IA and IB), or every 3 months for 5 years, then annually for another 5 years (patients with stages IIA, IIB, and IIC);
• based on a previous report (Melanoma Follow-up Study, or MELFO) involving follow-up annually for 10 years (in stage I), every 6 months for 2 years, then annually for another 8 years (in stage IIA), or every 4 months for 2 years, every 6 months during the 3rd year, then annually for another 5 years (in stages IIB and IIC).

During follow up, patients were checked for recurrences and new primary melanoma lesions. 

In summary, there was a small difference in the delay in diagnosis of recurrences or a new primary melanoma using a schedule that uses far fewer visits to the doctor than recommended by the current guidelines.