Schematic diagram of the computer simulation model.

For each simulation, patients transited from left to right of the model. Incident PCa cases were distributed to active surveillance or curative intent initial treatment ascertained by level of risk at diagnosis. Straight arrows indicated potential transition pathways over successive cycles. Curved arrows indicated cases remained on that health state over successive cycles. Transition between health states was ascertained by state transition probabilities and disease evolution. Following active surveillance or initial treatment, patients were subsequently treated for PCa recurrence and metastatic castration resistant prostate cancer (i.e. mCRPC) ascertained by state transition probabilities and disease evolution over successive cycles. Patients deceased from PCa or other causes exited the model.