Fig. 3
Multistate model used for the simulation of death data in people aged 15 years or older. Transition probabilities were obtained from national cancer incidence and survival and suicide mortality statistics: pH–S = transition probability from the initial healthy state to the absorbing suicide death state, pH–K = transition probabilities from the initial healthy state to the Kth cancer state, pH–O = transition probability from the initial healthy state to the absorbing other causes of death state, pK–H = transition probabilities from the Kth cancer state to the initial healthy state, pK–S = transition probabilities from the Kth cancer state to the absorbing suicide death state, pK–C = transition probabilities from the Kth cancer state to the absorbing Kth cancer death state, pK–O = transition probabilities from the Kth cancer state to the absorbing other causes of death state. The probability of suicide death for individuals in a Kth cancer state pK–S was obtained by multiplying the relative risk of suicide corresponding to the Kth cancer site by the national suicide mortality rate. In the first simulation study, the relative risks of suicide used were equal to one for every cancer site (to mimic the null hypothesis of no cancer/suicide association); in the second simulation study, those published in the study of Fang et al. were applied [28]