N-3 polyunsaturated fatty acids (PUFAs) have been suggested to affect depressive disorders. This review aims to determine the effect of n-3 PUFAs on depressive symptoms in people with or without diagnosed depression. Medline, PsycINFO, and Cochrane CENTRAL databases were searched for randomized controlled trials (RCTs) assessing the association between n-3 PUFAs and depressive symptoms or disorders as outcomes. A random-effects meta-analysis of standardized mean difference (SMD) with 95% confidence intervals (CI) was performed. Twenty-five studies (7682 participants) were included. Our meta-analysis (20 studies) indicated that n-3 PUFA supplementation lowered depressive symptomology as compared with placebo: SMD = −0.34, 95% CI: −0.55, −0.12, I² = 86%, n = 5836, but a possible publication bias cannot be ruled out. Subgroup analyses indicated no statistically significant difference by treatment duration of <12 vs. ≥12 weeks, presence of comorbidity, or severity of depressive symptoms. Nevertheless, beneficial effects were seen in the subgroups of studies with longer treatment duration and with no depression and mild to moderate depression. Subgroup analysis by eicosapentaenoic acid (EPA) dosage revealed differences in favor of the lower EPA dosage. Sensitivity analysis including studies with low risk of bias seems to confirm the overall result. Supplementation of n-3 PUFA appears to have a modest beneficial effect on depressive symptomology, although the quality of evidence is still insufficient.

The indirect impact of the COVID-19 pandemic on cancer care and timely diagnosis is of increasing concern. We investigated the impact of the COVID-19 pandemic on incidence, time of diagnosis and delivery of healthcare among paediatric oncology patients in Germany in 2020. We analysed incident paediatric cancer cases diagnosed in 0- to 17-year olds in Germany in 2020 using data of the German Childhood Cancer Registry. Absolute numbers and age-standardised incidence rates (ASR) in 2020 were compared to the previous five years (2015–2019). Moreover, we conducted a survey with open-ended questions, gathering perceptions of the diagnostic process and healthcare delivery for paediatric oncology patients during the COVID-19 pandemic. More or similar numbers of paediatric cancer patients were newly diagnosed each month throughout 2020 in comparison to the previous five years. The estimated ASRs showed markedly higher incidence rates, overall and across diagnostic groups, in 2020 compared to 2015-2019. Results from the qualitative survey indicated that diagnostic processes, timeliness of diagnosis, and delivery of treatment were hardly affected during the COVID-19 pandemic. However, psychosocial supportive care and non-urgent appointments were considerably reduced during the lockdown periods. We found no indications of severe adverse effects of the COVID-19 pandemic on diagnosis and delivery of healthcare among children with cancer in Germany. The underlying reasons of the increase in incidence rates remain speculative. Continued close monitoring of incidence patterns may shed light on the underlying reasons of the present increase and contribute to understanding disease aetiology. None

Childhood cancer is the leading disease‐related cause of death among under 15 year olds in Europe. Since primary preventive measures are lacking, improving survival probabilities and long‐term well‐being remain primary goals. With this report, we provide the first long‐term assessment and interpretation of patterns in childhood cancer survival in Germany, covering a period of 30 years. Using data from the German Childhood Cancer Registry, we assessed temporal patterns of cancer survival among children (0‐14 years) diagnosed in Germany from 1991 to 2016, by cancer type, age at diagnosis and sex. We calculated overall survival (OS) and average annual percentage changes of the respective 5‐year OS estimates. OS improved across all cancer types, age groups as well as for boys and girls over time. Five‐year OS for all childhood cancers combined increased from 77.8% in 1991‐1995 to 86.5% in 2011‐2016, with stronger improvements during the early 1990s. The most pronounced survival improvement was seen for acute myeloid leukaemia, at 2% annually and 5‐year OS recently reaching 81.5%. Survival improvements for some diagnoses such as neuroblastoma, renal tumours and bone tumours have flattened out. Tremendous enhancements in diagnostics, treatment and supportive care have affected average survival improvements for most cancer types. Recently, survival improvements have decelerated overall and for some cancer types, it plateaued at an unsatisfactory level. As not all children benefited equally from the survival improvements, personal factors (eg, socioeconomic circumstances, health literacy, access to care) likely affect individual prognosis and warrant further investigation.

Social inequalities in childhood cancer survival have been observed in many countries, including European nations with universal healthcare systems, suggesting that not all children with cancer have benefited equally from diagnostic and therapeutic enhancements. Despite the growing socioeconomic diversity within Germany's large population, little is known about the extent of social inequalities in German childhood cancer survival. Using German Childhood Cancer Registry data, we identified all children with a cancer diagnosis before the age of 15 years in 1997–2016 in Germany (N = 35,443). Based on individual residential address information (at time of diagnosis) we applied the German Index of Socioeconomic Deprivation (GISD) to measure area‐based socioeconomic status. Using Cox proportional hazards models, we assessed the association between absolute area‐based socioeconomic deprivation (AASD) and 10‐year overall survival (OS) (end of follow‐up: 15 January 2023) to estimate hazard ratios (HR) and corresponding 95% confidence intervals (CI). The multivariable analyses revealed a null association for AASD and 10‐year OS for all cancers combined (HR_adj = 1.00, 95% CI 0.97; 1.03). Among children diagnosed with acute myeloid leukaemia and germ cell tumors, a higher AASD (higher levels of deprivation) appeared to be associated with worse survival, particularly pronounced in boys. The opposite was observed among children diagnosed with central nervous system tumors. Contrary to reports from other European countries, we found little evidence for social inequalities in childhood cancer survival in Germany when analysing the GISD. Further research assessing individual‐level measures of socioeconomic status is warranted.

Background: Tumors of the central nervous system (CNS) are the second most common type of pediatric cancer in Germany. We aimed to describe registration practice, incidence, and survival patterns for childhood CNS tumors in Germany for the past 40 years.Procedure: Including all CNS tumor cases in children diagnosed at ages 0–14 years registered at the German Childhood Cancer Registry (GCCR) in 1980–2019 (for survival analysis 1980–2016), we calculated age‐specific and age‐standardized incidence rates (ASIR) over time, average annual percentage changes (AAPC), and 1‐ and 5‐year overall survival.Results: While we observed a pronounced increase in ASIR after the establishment of the GCCR during the 1980s, ASIR for all pediatric CNS tumors combined continued to increase markedly from 28.6 per million in 1990–1999 to 43.3 in 2010–2019 (AAPC = 2.7% in 1991–2010, AAPC = 0.3% in 2010–2019). The 5‐year overall survival from CNS tumors improved from 63% in the 1980s, 70% in the 1990s to 79% in 2010–2016. These improvements have occurred across all age groups. Children diagnosed with ependymomas and choroid plexus tumors experienced the strongest increase (from 54% to 81%).Conclusions: Observed increases in incidence rates for pediatric CNS tumors are likely only partially caused by actual increasing case numbers. The majority is a function of improved registration and, to a minor extent, improvements in diagnostics. Survival from pediatric CNS tumors has, by and large, improved consistently, leading to a growing population of childhood cancer survivors with diverse health biographies and risk of lifelong adverse impact on health and wellbeing.