OBJECTIVES Most cancer care models are based on observed clinical events such as recurrence-free and overall survival. Times at which events are recorded depend not only on effectiveness of treatment, but also on timing of examinations and types of tests performed. Should these change, observation times would change as well. Construct a microsimulation model that describes the cancer disease process using a description of underlying tumor growth as well as its interaction with diagnostics, treatments and surveillance. The aim is to arrive at a framework that allows for exploration of the impact of simultaneously altering two or more aspects of the care process. METHODS The framework consists of two components; the disease model and the clinical management module