Population-level economic burden of lung cancer in China:Provisional prevalence-based estimations,2017-2030

Objective:Population-level economic burden is essential for prioritizing healthcare resources and healthcare budget making in the future.However,little is known about the economic burden of lung cancer in China.Methods:A prevalence-based approach was adopted to estimate the economic burden of lung cancer,including direct expenditure(medical and non-medical)and indirect cost(disability and premature death).Data on direct expenditure and work-loss days per patient in each year post-diagnosis were obtained from two primary surveys.Other parameters were obtained from literatures and official reports.Projections were conducted based on varying parameters.All expenditure data were reported in United States dollars(USD)using 2017 value(exchange rate:1 USD=6.760 CNY),with the discount rate of 3%.Results:The total economic burden of lung cancer was estimated to be 25,069 million USD in China in 2017(0.121%of gross domestic productivity,GDP).The estimated direct expenditure was 11,098 million USD,up to1.43%of total healthcare expenditure for China,covering 10,303 million USD and 795 million USD for medical and non-medical expenditure,respectively.The estimated indirect cost was 13,971 million,including 1,517 million USD due to disability and 12,454 million USD due to premature death.Under current assumptions,the projected total economic burden would increase to 30.1 billion USD,40.4 billion USD,and 53.4 billion USD in 2020,2025,and 2030,accounting for 0.121%,0.131%,and 0.146%of China's GDP,respectively.However,if China meets the United Nation sustainable development goal of reducing premature death from non-communicable diseases by one-third by 2030,the total economic burden in 2030 would be 31.9 billion USD,0.087%of China's GDP.Conclusions:The economic burden of lung cancer in China in 2017 is substantial and more likely to increase significantly in the future.Policy makers need to take urgent actions in budget making for health systems.The economic burden could be alleviated by reducing the disease burden of lung cancer via effective control and prevention actions.

A population-level model from the microscopic dynamics in Escherichia coli chemotaxis via Langevin approximation

Recent extensive studies of Escherichia coli （E. coli） chemotaxis have achieved a deep understanding of its mi- croscopic control dynamics. As a result, various quantitatively predictive models have been developed to describe the chemotactic behavior of E. coli motion. However, a population-level partial differential equation （PDE） that rationally incorporates such microscopic dynamics is still insufficient. Apart from the traditional Keller-Segel （K-S） equation, many existing population-level models developed from the microscopic dynamics are integro-PDEs. The difficulty comes mainly from cell tumbles which yield a velocity jumping process. Here, we propose a Langevin approximation method that avoids such a difficulty without appreciable loss of precision. The resulting model not only quantitatively repro- duces the results of pathway-based single-cell simulators, but also provides new inside information on the mechanism of E. coli chemotaxis. Our study demonstrates a possible alternative in establishing a simple population-level model that allows for the complex microscopic mechanisms in bacterial chemotaxis.

Hypertension Prevalence,Awareness,Treatment,and Control and Their Associated Socioeconomic Factors in China:A Spatial Analysis of A National Representative Survey

Objective We aimed to investigate and interpret the associations between socioeconomic factors and the prevalence, awareness, treatment, and control of hypertension at the provincial level in China.Methods A nationally and provincially representative sample of 179,059 adults from the China Chronic Disease and Nutrition Surveillance study in 2015–2016 was used to estimate hypertension burden. The spatial Durbin error model was fitted to investigate socioeconomic factors associated with hypertension indicators.Results Overall, it was estimated that 29.20% of the participants were hypertensive nationwide,among whom, 34.32% were aware of their condition, 27.69% had received antihypertensive treatment,and 7.81% had controlled their condition. Per capita gross domestic product(GDP) was associated with hypertension prevalence(coefficient:-2.95, 95% CI:-5.46,-0.45) and control(coefficient: 6.35, 95% CI:1.36, 11.34) among adjacent provinces and was also associated with awareness(coefficient: 2.93, 95%CI: 1.12, 4.74) and treatment(coefficient: 2.67, 95% CI: 1.21, 4.14) in local province. Beds of internal medicine(coefficient: 2.66, 95% CI: 1.08, 4.23) was associated with control in local province. Old dependency ratio(coefficient:-3.58, 95% CI:-5.35,-1.81) was associated with treatment among adjacent provinces and with control(coefficient:-1.69, 95% CI:-2.42,-0.96) in local province.Conclusion Hypertension indicators were not only directly influenced by socioeconomic factors of local area but also indirectly affected by characteristics of geographical neighbors. Population-level strategies should involve optimizing supportive socioeconomic environment by integrating clinical care and public health services to decrease hypertension burden.