Caches are the most common files being written and updated in most cases, along with some preference files, and of course browser caches can get "out of hand" very easily. But my experience in the past was with system and library (top level) caches being corrupt or a problem or out of date (and flushing them out anytime before making updates to OS X) thru the use of Applejack (was safe, reliable on PowerPC and 10.4.11 and earlier).
Web browser disk cache can cause a lot of disk I/O, and can be slower or slow down a browser when it gets too big, out of control, than if kept to reasonable size, and if you have fast broadband is probably not all that necessary.
Which is why I wish more browser (Safari) would put a limit on space that history, cache, preview to xx days, nn MBs, or just clear on closing.
Scanning a hard drive for problematic files is one thing that any good decent disk maintenance program should be capable of doing, not just the drive indexes and directory.