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UK - Death and Disability Trends for Malignant
Neoplasms, Ages 15-44
C. Alegria 1,∗and Y. Nunes 1,2
1RiskMath Lda*
, Portugal
2LibPhys†
, Department of Physics, FCT-NOVA, Portugal
Correspondence*:
Corresponding Author
calegria@phinancetech.com
ABSTRACT
In this study we investigate the UK trends in death rates and disabilities for malignant neoplasms
for individuals aged 15 to 44 by computing excess death rates and excess disability claims, which
are the difference between observed death/disability rates and a given baseline for expected
death/disability rates. We measure changes in the behaviors of morbidity and mortality before the
Covid-19 pandemic with the post-pandemic period, for malignant neoplasms.
We show a large increase in morbidity (disabilities) and mortality due to malignant neoplasms
that started in 2021 and accelerated substantially in 2022. The increase in disability claims mirrors
the increase in excess deaths in 2022, and both are highly statistically significant (extreme events).
The results indicate that from late 2021 a novel phenomenon leading to increased malignant
neoplasm deaths and disabilities appears to be present in individuals aged 15 to 44 in the UK.
Keywords: malignant neoplasms, excess mortality, disability claims, UK trends
*Phinance Technologies - Humanity Projects
†LibPhys
1
UK - Death and Disability Trends for Malignant Neoplasms, Ages 15-44
1 INTRODUCTION
Beginning in early 2020, the world changed due
to the emergence of a global pandemic caused by
the SARS-CoV-2 virus which, in some individuals,
manifested in the form of Covid-19 viral disease. A
short-term increase in mortality rates was anticipa-
ted due to the impact of this novel virus. However,
excess mortality has continued in many countries.
Various possible explanations have been propo-
sed for this, including lasting effects of the virus,
lockdowns and the resulting impact on healthcare
delivery, and adverse effects of the new vaccines,
some of which are based on newly implemented
mRNA technology.
In order to establish the possible causation of the
mRNA vaccinations with the onset of rapid cancer
development, some scientists focus on animal stu-
dies, such as reported by (Eens, et al., 2023)[
1
].
These studies do not prove direct causation betw-
een the novel mRNA vaccinations and the onset of
cancer as they are usually based on small samples
and are aimed only at showing possible mechani-
sms of action (for example, the previous study was
performed on 1 mouse, with a very large dosage).
However, the reporting of case studies of rapid
growth malignant neoplasms in humans following
Covid-19 vaccine administration can be found in
the medical literature. Such examples include cases
of haematologic malignancies following administra-
tion of the mRNA Covid-19 vaccine produced by
Pfizer-BioNTech: A diffuse large B-cell lymphoma
and NK/T-cell lymphoma (Zamfir, et al., 2022) [
2
];
a rapid progression B-cell lymphoma (Sekizawa, et
al., 2022)[
3
]; two similar reports from (Mizutani,
et al., 2022)[
4
] and another one by (Goldman, et
al., 2021)[
5
]; and also a subcutaneous panniculitis-
like T-cell lymphoma following an adenovirus type
26 (Ad26) viral vector–based Covid-19 vaccination
produced by Janssen Pharmaceuticals (Kreher, et
al., 2022) [6].
Additional evidence that points towards a possible
relationship between the novel Covid-19 vaccinati-
ons and the development of malignant neoplasms
are not available in the form of population-based
studies where vaccinated and unvaccinated individu-
als are compared. However, in section 4.10 of their
draft paper, (Wiseman, et al., 2023)[
7
] the authors
show that cancer reports following the Covid-19
vaccinations are more numerous than for all previ-
ous vaccines combined since 1990, when querying
the VAERS
1
(Vaccine Adverse Events Recording
System)from the CDC (Center for Disease Control
and Prevention).
In this context, we performed several analyses sho-
wing excess mortality (all cause) since 2020, from
Europe to the US. We published a methodology
report to explain our estimates for excess mortality
(Alegria et al., 2024)[
8
], which is based on mea-
suring excess death rates instead of excess deaths.
By accurately measuring, and then tracking, excess
mortality trends, we can have a clearer picture of the
implications of the different stages of the Covid-19
pandemic, as mentioned above.
The focus of this study is not to examine indi-
vidual claims and anecdotes, but instead to pro-
vide a statistical analysis at a population level.
Our analysis offers insight for health professionals
regarding current trends in population health and
uncovers relationships between these trends and the
significant events of the past few years.
2 DATA
2.1 Cause of Death Data
The data used in this analysis is the number of
deaths that occurred in England and Wales between
2010 and 2022, by underlying cause code (ICD-10),
sex, and age group (up to 90+). The source is the
UK Office for National Statistics (ONS). The direct
links to the mortality data by cause for 2010 to 2021
and 2022 are listed below:
Death occurrences by sex, five year age group and
underlying cause (ICD-10 code) England and Wales:
2022 - Office for National Statistics (ons.gov.uk)
(link to the 2022 data source)
(direct link to download the source file).
1https://wonder.cdc.gov/vaers.html
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UK - Death and Disability Trends for Malignant Neoplasms, Ages 15-44
Death occurrences by sex, five year age group
and underlying cause (ICD-10 code) England and
Wales: 2010 to 2021 - Office for National Statistics
(ons.gov.uk)
(link to the 2010-2021 data source)
(direct link to download the source file).
2.2 Registered Deaths (All Deaths)
Registered deaths are all the deaths registered
in England and Wales, independently of whether
a cause of death has been attributed. The investi-
gation of deaths and attribution of ICD-10 codes
with a cause of death can take up to 2 years to be
performed.
UK Monthly Registered Deaths (All Cause):
Deaths registered monthly in England and Wales
- Office for National Statistics (ons.gov.uk)
(link to the source).
2.3 Disability Claims
For investigating the changes in disability claims,
we use data from the Personal Independence Pay-
ment (PIP) system of the Department for Work and
Pensions (DWP). We analyze changes in PIP clea-
rances for new claims to the system, as explained
in our previous analysis, published on Phinance
Technologies website2.
Source for PIP data (from DWP): Personal Inde-
pendence Payment statistics April 2013 to January
2023 (link).
Stat-Xplore system for DWP databases: (link).
3 METHODOLOGY
In this study, we investigate the trends in death
rates and disability claims for the selected cause:
malignant neoplasm (or oncologic causes for PIP
disability claims). We investigate these trends using
yearly data and therefore we do not have to perform
a seasonal adjustment to the data.
2
Phinance Technologies - Humanity Projects - Analysis of UK New Claims
for Personal Independence Pension (PIP) by Body System.
In general terms, to measure trends in these vari-
ables we use a methodology of computing excess
rates, which is the difference between the actual
observed rates and a given baseline (expected rates).
Because we want to measure the impact of the
Covid-19 pandemic and post-pandemic periods rela-
tive to the prior state of the world, our baselines are
based upon the estimation of the trend for a period
prior to the pandemic.
In this study we will use method 2C, as descri-
bed in our report on methodologies for measuring
excess deaths in the population (Alegria C., et al.,
2024)[
8
]. Method 2C is based on computing the
trends in death rates (deaths adjusted by the popula-
tion) instead of deaths, as the baseline for estimating
excess mortality. This method significantly redu-
ces the noise of the estimation as it adjusts for
population growth or decline, and by also provi-
ding different rates for each age category, we adjust
for changes in population age distribution. The
method also considers the prior trend in death rates,
which tend to decline over time as the population
grows healthier and different risk factors are better
managed.
3.1 Method 2C for Estimating Excess
Death Rates
Excess
DeathsAG
ti
=DeathsAG
ti
−BaselineAG
ti(1)
Equation 1 is a general expression for estimating
the excess absence rates relative to a given base-
line. We use the superscript
AG
to indicate a given
population age range, as this is the primary focus
of the current analysis. Other cohorts which this
equation could apply to include a specific region,
sex, or underlying cause of death. The subscript
ti
refers to time, that is, the corresponding year for
which the excess deaths are computed.
For estimating the baseline for “normal or expe-
cted” death rates we use a simple linear fit:
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UK - Death and Disability Trends for Malignant Neoplasms, Ages 15-44
Baseline(ti) = ˆ
b+ ˆa(ti−t0)(2)
Where
ˆa
and
ˆ
b
are the estimated coefficients of the
death rate trendline from 2010 to 2019. It should
be noted that for the UK disability data (Personal
Independence Payment (PIP) system) the estimation
period we use is from 2016 to 2019. The data before
2016 is unreliable due to the transition from the
prior system of Disability Living Allowance (DLA)
to the PIP system in 2013, which only stabilized
after 2015.
3.2 ICD-10 Code List of Selected Causes
of Death for: Malignant Neoplasms
For this analysis we selected all the ICD-10 codes
from category C, namely C00 to C99 which refer to
deaths attributed to malignant neoplasms. It should
be noted that ICD-10 codes C98 and C99 were not
used in the ONS cause of death datasets and con-
sequently, ICD-10 codes C00-C97 or C00-C99 are
equivalent and will be used interchangeably throu-
ghout this report. Some ICD-10 codes, such as C27
with the generic description of “Malignant neopla-
sms” refer to ICD-10 codes that were not used in
the UK from 2010 to 2022.
The detailed list that was extracted from the ONS
cause of death database shows the codes and descri-
ption that were aggregated for the purpose of our
analysis. The list is shown in Annex 7.
4 YEARLY ANALYSIS OF TRENDS IN
DEATH RATES FOR AGE GROUP
15-44
In this section we perform a yearly analysis of the
death rates for England and Wales, using the ONS
cause of death data. In this analysis we use the 2010-
2019 trend in death per 100,000 (death rates) as the
baseline estimate for excess death rates. Excess
death rates for the 2010-2019 period are in-sample
while the rates for 2020, 2021, and 2022 are out of
sample computations.
The analysis is performed for all the deaths from
a range of underlying causes of death, as described
by the list of ICD-10 codes in section 3.2, which
refer to all deaths from malignant neoplasms.
Our analysis is structured in multiple layers due to
the available data on the cause of deaths for the UK
being incomplete. Consequently, we first need to
investigate the overall degree of missing data in the
ONS cause of death databases, which is performed
in section 4.1.
Secondly, in order to have a reference for com-
parison, we investigate trends in registered deaths,
which are deaths from any cause that occurred in
England and Wales, for the 15 to 44 age group. This
analysis is performed in section 4.2.
In section 4.3 we analyze trends in death rates
from malignant neoplasms without performing an
adjustment to the data that corrects for the missing
records in the ONS cause of death datasets. The
missing records are due to delays in the attribution
of death certificates, which is particularly notice-
able in younger individuals. By excluding deaths
without a known cause of death, this analysis provi-
des a lower limit for excess mortality trends due to
malignant neoplasms.
In section 4.4 we analyze the trends in adjusted
death rates, where deaths are scaled proportio-
nally according to the estimated amount of missing
records in the ONS cause of deaths datasets.
Finally, section 4.5 investigates trends in the fra-
ction of malignant neoplasm deaths by deaths from
all causes in the ONS cause of death databases. This
analysis is another way of correcting for the mis-
sing records in the data and shows the growth or fall
of malignant neoplasm deaths relative to all other
causes.
4.1 Deaths for All Causes Versus
Registered Deaths
When analyzing the ONS data for cause of death
we noticed that there are discrepancies between the
number of deaths which have a cause of death and
the number of registered deaths for a year. This is
particularly striking for the case of deaths in 2022
(the most recent year) and for younger individuals,
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where there are significant discrepancies between
both these datasets.
The reason for the discrepancy is that death certifi-
cates for younger individuals take longer to produce
as each many of these deaths are thoroughly exami-
ned and, on many occasions, post-mortems need to
be performed. For older individuals, the discrepa-
ncies are small. In this report we only investigate
deaths for individuals aged from 15 to 44. For this
age group, we show the differences between regi-
stered deaths and all the known causes of deaths in
Figure 1.
Figure 1. England and Wales, registered deaths
versus deaths from all causes in the ONS deaths by
cause data table for age group 15 to 44. Top: Yearly
numbers. Bottom: Percentage of missing cause of
death relative to registered deaths.
We can observe that the discrepancy between regi-
stered deaths and the sum of all deaths by cause
ranges between -3% to +3% from 2010 to 2020.
We consider these normal discrepancies between
these databases as there are many factors that could
lead to these discrepancies, including if the deaths
occurred within England and Wales or abroad, or
if the individuals were only temporarily staying in
England and Wales.
For 2021, however, we observe about 8% more
registered deaths than the sum of the deaths from
all causes. In 2022, there are still about 32% of
registered deaths without a final cause of death. This
is a large discrepancy that needs to be corrected
(Office for National Statistics (ONS), UK) [9].
To correct for the discrepancies in registered dea-
ths compared to deaths from all causes, we scale
the deaths for each ICD-10 code by the ratio
R=
(registered/allcausedeaths)
. This adjustment is
significant for 2022 and assumes that the propor-
tion of deaths from the different ICD-10 codes will
remain the same after the final figures are published
in 1 or 2 years. This may not be the case and, the-
refore, the results need to be taken with a degree
of caution. In particular, deaths from drug-related
causes and suicide can have delayed reporting3.
In summary, to estimate the trends in death rates
for different causes, we use Adjusted Deaths (Adj-
deaths) which refers to the deaths from a particular
cause or range of causes adjusted by the ratio defi-
ned above. Adjusted death rates are computed based
on adjusted deaths. We also analyze the trends in
unadjusted deaths, that do not take account of the
missing data. This analysis is obviously incorrect as
it assumes that no further deaths in 2021 and 2022
will be attributed to malignant neoplasms once the
cause of death is established. Nevertheless, this is
useful as it provides a lower limit when observing
trends in excess mortality for these particular ICD-
10 codes. The final data, when it is released by the
ONS, is likely to fall in between the analysis of
unadjusted deaths and the adjusted deaths using the
proportional adjustment method described above.
3
ONS - Impact of registration delays on mortality statistics in England and
Wales: 2021
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UK - Death and Disability Trends for Malignant Neoplasms, Ages 15-44
4.2 Trends in death rates for registered
deaths (all-cause)
The analysis of the registered deaths allows us
to have a context by which we can then compare
the death rates for malignant neoplasms. Figure 2
shows the death rate per 100,000 individuals for all
registered deaths in England and Wales from 2010
to 2022. We can observe that registered deaths per
year had been trending slightly lower from 2010 to
2019.
Figure 2. Yearly registered deaths per 100,000 for
England and Wales. The red dashed line shows the
average from 2010 to 2019. The dotted line shows
the extrapolation of the trend from 2020 until 2022.
In 2019, the death rate was about 67 per 100,000
individuals aged 15 to 44. The death rate increased
in 2020 to about 69 per 100,000 and then again
in 2021 to 75 per 100,000. In 2022 the death rate
dropped slightly to about 71 per 100,000, the same
level as observed in 2010 and still above the 2020
level.
4.2.1 Excess registered death rates
Figure 3 shows the excess death rate for registe-
red deaths (all-cause) in England and Wales from
2010 to 2022. Figure 3 (top) refers to relative devi-
ations from the 2010-2019 trend, while Figure 3
(bottom) shows the Z-score (signal strength) for the
deviations from trend.
Figure 3 shows that excess deaths in 2020 were
around 7%, with a Z-score of 2.1. These values
Figure 3. Excess registered death rates in England
and Wales for both sexes with ages 15 to 44. Top:
Relative deviation from trend, percent. Bottom:
Deviation from trend Z-Score.
indicate some level of statistical significance, which
could imply that the 15-44 age group suffered a
small level of excess mortality in 2020. In 2021
excess deaths jumped to around 15% with a Z-score
above 5 indicating very high statistical significa-
nce. Excess deaths in 2022 were about 10% with a
Z-score of about 3.5 indicating high statistical signi-
ficance. Excess death levels remained abnormally
high in 2022, especially if one considers that the
Covid-19 variants were successively milder.
The pattern of all-cause mortality shown in Figure
3 will provide an interesting baseline for comparing
deaths from malignant neoplasms.
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UK - Death and Disability Trends for Malignant Neoplasms, Ages 15-44
4.3
Trends in unadjusted death rates from
Malignant Neoplasms (C00-C99)
The first analysis that we perform is the analysis
of the unadjusted (raw) deaths from malignant neo-
plasms. Before starting the analysis, it needs to be
reiterated that as mentioned in section 4.1, there are
a significant number of missing records for causes
of death relative to registered deaths in 2021 and
2022. This is particularly the case for younger indi-
viduals, whose deaths are more likely to require
investigation to understand the underlying causes.
4.3.1 Unadjusted death rates (raw data)
In section 4.1 we observed that for the 15-44 age
group, there are about 8.3% of missing records
in 2021 in the ONS cause of death dataset, and
32% for 2022. The missing records for 2022 are
about a third, which means that when analyzing
the raw numbers of deaths (without adjustment) for
malignant neoplasms, they will likely under-report
actual deaths by that amount.
With these caveats in mind, Figure 4 shows
the number of deaths (right) and death rate per
100,000 individuals (left) for malignant neoplasms
in England and Wales from 2010 to 2022, as provi-
ded by the original data sources. Even with a large
number of missing records, we can already observe
a clear signal in above-trend malignant neoplasm
deaths in both 2021 and 2022.
4.3.2 Excess unadjusted death rates
Figure 5 shows the excess death rate for unadju-
sted deaths from malignant neoplasms in England
and Wales from 2010 to 2022. Figure 5 (top) refers
to relative deviations from the 2010-2019 trend,
while Figure 5 (bottom) shows the Z-score (signal
strength) for the deviations from trend.
The results show that there is no noticeable signal
pointing to abnormal excess death rates from mali-
gnant neoplasms from 2010 to 2021 (with Z-scores
ranging from -1.5 to +1.5). However, in 2022,
excess deaths from malignant neoplasms were about
4.3% with a correspondent Z-score of about 3, repre-
senting a very strong signal in spite of the 32% of
Figure 4. Yearly unadjusted (raw) deaths from
malignant neoplasms in England and Wales, with
missing datapoints in 2021 and 2022. The red
dashed line shows the average from 2010 to 2019.
The dotted line shows the extrapolation of the trend
from 2020 until 2022. Top: Deaths per 100,000.
Bottom: Deaths (number).
missing data points. Once the remaining registe-
red deaths have their cause attributed, this signal is
likely to be even stronger.
4.4 Trends in adjusted death rates from
Malignant Neoplasms (C00-C99)
In this section we investigate the trends in adju-
sted death rates in England and Wales for the 15-44
age group. We also compare all-cause mortality
(registered deaths) with adjusted deaths from mali-
gnant neoplasms. The adjustment to the deaths rates
was performed using the methodology described
in section 4.1, that is, by scaling causes of deaths
proportionally.
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Figure 5. Excess unadjusted death rates for disea-
ses by malignant neoplasms in England and Wales.
Top: Relative deviation from trend, percent. Bottom:
Deviation from trend Z-Score.
4.4.1 Adjusted death rates
Figure 6 (top) shows the death rate per 100,000
individuals for malignant neoplasms deaths (adju-
sted for under-reporting) in England and Wales from
2010 to 2022. We can observe that deaths per year
from malignant neoplasms have been trending lower
from 2010 to 2019, with a significant downward
slope. In 2010 the death rate was 15 per 100,000
and in 2019 it was around 12.8 per 100,000, a 14.7%
drop.
The adjusted death rate dropped further in 2020 to
about 12.5 per 100,000. In 2021 the adjusted death
rate rose to 14 per 100,000 and in 2022 the death
rate increased again to about 17.5 per 100,000, a
level that is 11.7% higher than observed in 2010.
The death rate in 2022 was about 4.7 deaths per
100,000 above the 2015-2019 average.
Figure 6. Yearly adjusted deaths for diseases by
malignant neoplasms in England and Wales. The
red dashed line shows the average from 2010 to
2019. The dotted line shows the extrapolation of the
trend from 2020 until 2022. Top: Adj-Deaths per
100,000. Bottom: Adj-Deaths (Number).
When translating these numbers into the absolute
number of deaths from malignant neoplasms, shown
in Figure 6 (bottom), we can observe that the 5-year
average deaths from 2015 to 2019 was about 3,000
deaths. In 2020, malignant neoplasm deaths were
about 2,800, 200 less than the prior 5-year average.
In 2021 there were about 3200 deaths, which was
200 more than the 2015-2019 average. In 2022,
the number increased to 4000, 1000 more than the
2015-2019 average.
4.4.2 Excess adjusted death rates
In this section we investigate the trends in excess
adjusted death rates in England and Wales for the
15-44 age group. We compare excess all-cause mor-
tality (registered deaths) with excess deaths from
malignant neoplasms.
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Figure 7 compares the excess death rate for mali-
gnant neoplasms (adjusted for under-reporting) and
excess registered deaths in England and Wales from
2010 to 2022. Figure 7 (top) refers to relative devi-
ations from the 2010-2019 trend, while Figure 7
(bottom) shows the Z-score (signal strength) for the
deviations from trend.
Figure 7. Excess adjusted death rates for disea-
ses by malignant neoplasms in England and Wales.
Top: Relative deviation from trend, percent. Bottom:
Deviation from trend Z-Score. Excess death rates
for all registered deaths are shown for comparison
(Solid blue).
In Figure 7 (top) we can observe that the adju-
sted excess deaths rate from malignant neoplasms
were close to zero in 2020, rose by about 13% in
2021, and about 43% in 2022. The excess mor-
tality for all registered deaths was about 5% in
2020, 15% in 2021, and 10% in 2022. Interestin-
gly, the drop in excess mortality for all registered
deaths from 2021 to 2022 was not mirrored in a
drop in adjusted malignant neoplasm deaths. In fact,
the opposite occurred, with a sharp acceleration in
adjusted excess deaths due to malignant neoplasms.
In terms of statistical significance of the excess
deaths, we observe from Figure 7 (bottom) that for
all registered deaths, the Z-score in 2020 was only
about 2, which is not a strong signal. However, in
2021, the Z-score was slightly above 5 which is
a very strong signal. In 2022 the Z-score dropped
to about 3.5, which still indicates that the excess
deaths are a statistically significant deviation from
the 2010-2019 trend.
When looking at excess deaths from malignant
neoplasms, the Z-score in 2020 was around 0, indi-
cating no signal pointing to an increase in malignant
neoplasm deaths. That trend however accelerated
substantially in 2021 and 2022 where we observe
Z-scores of around 5 and 16, respectively. These
are extreme events.
4.4.3 Adjusted death rates for males and
females
When looking at deaths attributed to malignant
neoplasms for males and females, shown in Figure
8, we observe that historically females have about
33% higher death rates from malignant cancers than
men. From 2010 to 2020 death rates from malignant
neoplasms have been trending down for both coh-
orts, with visible breaks to the trend in 2021 and
2022, as shown in Figure 8. For females, death
rates were 16.1 per 100,000 in 2010 and dropping
to 13.9 per 100,000 by 2020, a 13.7% drop. For
males, death rates were 13.6 per 100,000 in 2010
and dropping to 10.5 per 100,000 by 2020, a 22.8%
drop.
In 2021 adjusted death rates from malignant neo-
plasms rose by 1.6 per 100,000 to 15.5 per 100,000
for females and by 1.7 per 100,000 to 12.2 per
100,000 for males.
In 2022 adjusted death rates from malignant neo-
plasms rose further to 18 per 100,000 for females
and to 16 per 100,000 for males. The absolute rise
in death rates was more pronounced for males than
females, with adjusted deaths rates rising from 2020
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levels by 5.5 per 100,000 in males, while only by
4.1 per 100,000 in females. Cancer death rates in
2022 for both males and females were substantially
above 2010 levels, reversing the improvements in
mortality from malignant neoplasms observed from
2010 to 2020.
Figure 8. Yearly adjusted death rates for diseases
by malignant neoplasms in England and Wales, for
males and females. The red dashed line shows the
average from 2010 to 2019. The dotted line shows
the extrapolation of the trend from 2020 until 2022.
4.4.4 Excess adjusted deaths rates for
males and females
When looking at adjusted excess deaths (mea-
sured as deviations from the 2010-2019 trend)
attributed to malignant neoplasms for males and
females, shown in Figure 9, we observe that in
2020, neither group had any noticeable excess mor-
tality, with respective Z-scores close to zero (low
statistical significance).
However, we also observe that in 2021 men suffe-
red slightly worse outcomes than women, with men
experiencing a 16% deviation from trend, compa-
red to about 10% for women. In 2022 men suffered
much worse outcomes than women, with men expe-
riencing a 52% deviation from trend, compared to
about 31% for women. The signal strengths for both
men and women were highly statistically significant,
as shown in Figure 9 (bottom).
Figure 9. Excess adjusted deaths rates by mali-
gnant neoplasms for males and females, in England
and Wales. Top: Relative deviation from trend,
percent. Bottom: Deviation from trend Z-Score.
4.5 Trends in fraction Malignant
Neoplasms (C00-C99) deaths versus
deaths from all causes
In this section we analyze the trends in the relative
incidence of malignant neoplasm deaths relative to
all other causes, which provides a different type of
information related to breaks in the normal pattern
of deaths in this age group.
4.5.1 Fraction of deaths from Malignant
Neoplasms (C00 to C99) Versus All
Causes
For this purpose, in Figure 10 we plot the fra-
ction of deaths from all causes that are attributed to
malignant neoplasms. We observe that there was a
slightly declining trend in the fraction of deaths due
to malignant neoplasms from 2010 to 2019. In 2010,
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deaths attributed to malignant neoplasms accounted
for 21% of total deaths, while in 2019, the fraction
was only 19.5%.
Figure 10. Fraction of all causes for yearly dea-
ths attributed to malignant neoplasms, for England
and Wales. The red dashed line shows the ave-
rage from 2010 to 2019. The dotted line shows
the extrapolation of the trend from 2020 until 2022.
In 2020 the fraction of deaths due to malignant
neoplasms dropped to about 17.5% of total deaths.
The fraction then increased to 18.5% in 2021 (back
in line with the 2010-2019 trendline) and then jum-
ped to about 24.5% in 2022, which is significantly
above the 2010 level.
4.5.2 Excess Fraction of deaths from
Malignant Neoplasms (C00 to C99)
Versus All Causes
A different perspective is to analyze the fraction
of deaths from all causes that are attributed to
malignant neoplasms and compare them with the
absolute changes in death rates due to malignant
neoplasms, as shown in Figure 11.
We observe that in 2020 and 2021 the fraction
of malignant neoplasm deaths relative to all other
causes did not deviate significantly from the 2010-
2019 trend. In 2021, both registered deaths and
malignant neoplasm deaths increased by similar
amounts so that the fraction of neoplasm deaths
remained unchanged. For 2022, we observe that
in similarity with excess death rates, the fraction
of neoplasm deaths jumped substantially, by about
30%.
When looking at the statistical significance of the
signals, in 2022, the fraction of excess deaths due
to malignant neoplasms had a Z-score of about 16,
similar in magnitude than that for excess adjusted
deaths rates. This reinforces the fact that deaths
related to the malignant neoplasms are of particu-
lar concern for this age group and needs further
investigation.
Figure 11. Excess fraction of all deaths that were
from malignant neoplasms for ages 15 to 44, in
England and Wales. Top: Relative deviation from
trend, percent. Bottom: Deviation from trend Z-
Score. Excess adjusted deaths rates for malignant
neoplasms are also shown for comparison (Red
dots).
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UK - Death and Disability Trends for Malignant Neoplasms, Ages 15-44
4.6 Summary of the Analysis of Death
Rates
We started our analysis of excess death rates due
to malignant neoplasms by showing that the analy-
sis needs to be performed with caution as not all
deaths had a classified cause up to the time of publi-
cation of the ONS dataset. This issue is particularly
relevant in younger age groups, which is the case
of the present analysis, where we observe that in
2022 about 32% of registered deaths were still not
classified with a cause (Figure 1).
We perform a correction to this problem by extra-
polating the deaths in each year as if the proportion
of each cause of death will remain the same when
the missing deaths are finally classified. This is
an assumption that must be taken with care. To
make sure that we are identifying an actual trend
in the data, we also analyze the deaths from mali-
gnant neoplasms relative to all classified causes of
death (Figure 11). The results show that the rise
in deaths from malignant neoplasms in 2022 was
similar to the relative rise in malignant neoplasms
in relation to all other causes. We also analyze raw
unadjusted deaths (Figure 5) which shows that even
without accounting for the missing records, 2022
already shows significant above-trend deaths from
malignant neoplasms.
Our analysis shows that the adjusted excess death
rates from malignant neoplasms were close to zero
in 2020, rose by about 13% in 2021, and about 43%
in 2022. On the other hand, the excess mortality for
all registered deaths was about 5% in 2020, 15% in
2021, and 10% in 2022. The drop in excess mor-
tality for all registered deaths from 2021 to 2022
was not mirrored in a drop in adjusted malignant
neoplasm deaths. The opposite occurred, with a
sharp acceleration in excess deaths due to malignant
neoplasms.
The excess mortality from malignant neoplasm
deaths in 2021 and 2022 are highly statistically
significant with Z-scores of 5 and 16, respectively.
These are very strong signals. As mentioned above,
these signals are corroborated by similar findings
when measuring rises in the fraction of deaths from
malignant neoplasms relative to all other deaths
with classified causes.
When translating these numbers into the absolute
number of deaths from malignant neoplasms, in
2020, these were about 2765, 38.8 less than the
extrapolated 2010-2019 trend. In 2021, there were
about 3143 deaths (374.4 more than the extrapolated
trend), and in 2022, 3939 deaths, which is 1187
more than the 2010-2019 trend.
When comparing outcomes for men and women,
shown in Figure 9, we observe that both had no
significant changes in deaths from malignant neo-
plasms in 2020. However, in 2021 men suffered
slightly worse outcomes than women, with men
experiencing a 16% deviation from trend, compa-
red to about 10% for women. In 2022 men suffered
much worse outcomes than women, with men expe-
riencing a 52% deviation from trend, compared to
about 31% for women. The signal strengths for both
men and women were highly statistically significant,
as shown in Figure 9 (bottom).
The timelines of these changes in mortality rates
may help us to analyze whether the pandemic rules,
lockdowns, vaccines, or Covid-19 itself have pla-
yed a role in the rise of malignant neoplasm deaths.
Although the initial pandemic measures did affect
access to healthcare for routine matters, and in
some cases also affected people’s willingness to
attend healthcare facilities for more serious conditi-
ons, the stability in mortality rates from malignant
neoplasms in 2020 suggests that ‘lockdowns’ did
not significantly increase the risk of death for peo-
ple undergoing cancer treatment during that year.
Rather, the increase in mortality began in 2021. This
could indicate a lagged effect of the reduced access
to healthcare provision, for example due to delayed
diagnosis and treatment of malignant neoplasms, or
from the lasting impact of the virus on those who
were exposed to it. However, this timeframe also
coincides with the large-scale rollout of the Covid-
19 vaccines in the UK in 2021. The acceleration in
malignant neoplasm excess deaths in 2022, despite
a reduction in overall excess mortality rates, makes
any lagged effect from the 2020 pandemic measures
ResearchGate PrePrint 12
UK - Death and Disability Trends for Malignant Neoplasms, Ages 15-44
less likely as a significant cause of excess cancer
mortality. Unfortunately, the lack of monthly or
weekly breakdown in mortality by cause, from the
ONS, makes it difficult to compare malignant neo-
plasm mortality to other factors such as Covid-19
waves, or the vaccine rollout program. We will now
turn our analysis to the increase in disability claims
since the outbreak of the pandemic. The disability
data for the UK, unlike the mortality statistics from
the ONS, is broken down by month, and this may
help us to pinpoint where the increase in malignant
neoplasm morbidity began. Consequently, in the fol-
lowing section, we will be able to plot disabilities
alongside the rollout of the Covid-19 vaccination
program.
5
ANALYSIS OF UK DISABILITIES (PIP
SYSTEM)
In this section we investigate the trends in disability
claims in the UK’s Department for Work and Pensi-
ons (DWP) Personal Independence Payment (PIP)
system related to oncologic causes, to compare
these trends with the previous chapter on excess
mortality due to malignant neoplasms. The analy-
sis we present here refers to clearances from new
claims to the system. It should be noted that cleara-
nces refer to decisions made, which can be positive
or negative. The fraction of positive clearances, lea-
ding to a grant allowance, is shown to be stable over
time at a rate of about 40%.
One must be aware that PIP replaced the UK’s pre-
vious Disability Living Allowance (DLA) system in
2013 and therefore we observe a sharp increase
in claims in the few years following the initia-
tion of PIP, which has been explained as “capacity
issues” by the DWP. For this reason, only cases after
January 2016 are included in this set of analyses.
5.1 Methodology
The methodology we use to estimate excess clea-
rances of new claims in the PIP system is similar to
that on measuring excess mortality, described pre-
viously in section 3. We compare the 2016 to 2019
trendline in PIP clearances with actual claims and
compute the deviation from trend in relative terms
(percentage deviation).
5.2 Baseline PIP Clearances for New
Claims for Oncological Causes
Figure 12 shows the monthly PIP clearances for
oncologic causes from January of 2016 to January
of 2023. The dotted line refers to the cumulative
Covid-19 vaccine doses as a percentage of the 16-44
age group , which is illustrated to show the timing
of the changes in disability claims relative to the
vaccination campaign.
Figure 12. Monthly clearances (decisions) for new
claims to the Personal Independence Payment (PIP)
system in the UK, for oncological causes. The red
line shows the 2016-2019 trend and the dotted line
refers to the cumulative vaccinations for the 15-44
age group
From 2016 to 2019 we observe that there was an
average of about 450 new PIP clearances per month.
During 2020, we observe a large spike in March
that appears to be a correction in the below-average
PIP clearances in December 2019 and January 2020.
For the first 6 months of 2021 we observe a below-
average number of new monthly claims. However,
from mid-2021, we observe a systematic rise in
the PIP clearances, reaching a peak of 750 in Janu-
ary of 2023. During 2022 new PIP monthly claims
averaged about 630.
The results above seem to corroborate the prior
findings of increased deaths attributed to malignant
ResearchGate PrePrint 13
UK - Death and Disability Trends for Malignant Neoplasms, Ages 15-44
neoplasms. However, the results can be better com-
pared by performing a yearly analysis of the PIP
clearances.
5.3
Excess Yearly PIP Clearances for New
Claims for Oncological Causes
When we compute the yearly PIP clearances from
new claims for oncologic causes, shown in Figure
13, we observe that PIP clearances were very stable
from 2016-2019 for the 16-44 age group, at around
5478 per year.
Figure 13. Yearly excess clearances for new claims
to the Personal Independence Payment (PIP) system
in the UK for oncologic causes for ages 16 to 44.
The dotted line refers to the 2016 to 2019 average
yearly number of new claims.
In 2020 PIP claims increased by about 1.7%,
which was a slight increase from the 2016-2019
average. In 2021, PIP clearances were 0.1% below
the baseline. However, in 2022, PIP clearances jum-
ped by about 39.4%, relative to the baseline. We
should recall that for excess deaths from malignant
neoplasms, were close to zero in 2020, rose by
about 13% in 2021, and about 43% in 2022.
We should note that there was a backlog in PIP
clearances peaking in August of 2021 which led
to claims taking up to 26 weeks to clear. The
DWP mentions that the situation was normalized
from early 2022 (UK - Department for Work and
Pensions)[
10
], with PIP claims clearing in about
14 weeks
4
. Consequently, we must observe caution
when directly comparing the timing of excess deaths
with excess disability claims. However, on a yearly
basis, these differences are smoothed out, as obse-
rved by the similarity of the trends in both excess
deaths and excess disability claims for oncological
causes.
5.4 Commentary of the Analysis of PIP
Clearances for New Claims
Our previous analysis shows that there was a large
rise in PIP new claims that started around mid-2021
(see Figure 12) and accelerated in 2022. In 2022,
PIP clearances jumped by about 39.4%, relative to
the baseline. These results corroborate the previous
analysis of trends in death rates due to malignant
neoplasms. The increase in PIP new claims were
likely delayed by the delay in the process from a
PIP registration until a PIP clearance, which can
take 14 weeks or more.
The onset of disability after the Covid-19 vacci-
nations is already reported in the literature sources.
Three population-based studies from South Korea
show a relationship between the Covid-19 vacci-
nations and subsequent diverse non-fatal adverse
events. The authors compare the incidence rates of
different non-fatal health conditions in vaccinated
versus unvaccinated individuals. The three types of
adverse effects that were investigated are Immune-
related adverse effects (Suhet al., 2023)[
11
], Haem-
tological disorders (Choi, et al., 2023)[
12
] and
inflammatory musculoskeletal disorders (Park, et
al., 2023)[13].
4
Personal Independence Payment statistics April 2013 to January 2023 -
Clearance and Outstanding Times
ResearchGate PrePrint 14
UK - Death and Disability Trends for Malignant Neoplasms, Ages 15-44
Looking back to the original clinical trials for
the mRNA Covid-19 vaccines, (Fraiman, et al.,
2022)[
14
], show that the combined rate of serious
adverse events during the 2 to 3 months blinded
period of the Pfizer and Moderna clinical trials was
13.2 in 10,000 (vaccine arm relative to placebo arm
of the clinical trial)
5
. This translates to vaccinated
individuals having a rate of serious adverse events
of about 1 per 760. Our research into US disabilities
shows that the timing of the vaccination rollout was
synchronous with the start of the rise in disabilities
in early 2021, as well as showing a high correla-
tion between the cumulative disabilities and vaccine
doses, and a relationship between the rate of excess
disabilities and the rate of serious adverse events
described by Fraiman et al[14].
All this evidence points towards the novel mRNA
vaccines having played a significant role in the rise
in disabilities (from all causes) from 2021. After
this relationship was established the analysis of the
UK PIP system allowed for more granularity in
terms of investigating the underlying cause
6
for the
increase in disabilities, one of which was due to
oncologic diseases, discussed here.
Fraiman et al.’s[
14
] paper does not account for
serious adverse events that might have originated
some time after the Covid-19 inoculations. For
instance, in our previous report on Cardiovascular
deaths for 15 to 44 year-olds in the UK (Ale-
gria, 2023)[
15
], we show that cardiovascular deaths
increased over time and in 2022 reached their high-
est levels. This occurred more than 6 months after
the main vaccination rollout for the 15-44 age
group.
Similarly, it is possible that the rise in disabilities
and deaths from malignant neoplasms has an underl-
ying pattern that leads to a lag between the Covid-19
inoculations and the manifestation of the effect. Our
results show that malignant neoplasms disabilities
and deaths went up later than cardiovascular deaths,
5
Phinance Technologies - Humanity Projects - SAE in mRNA vaccine
Clinical Trials
6
Phinance Technologies - Humanity Projects - Analysis of UK New Claims
for Personal Independence Pension (PIP) by Body System.
mainly in 2022, while cardiovascular deaths had
started rising earlier, in 2020, and accelerated in
2021.
6 CONCLUDING REMARKS
The analysis of PIP clearances for new claims
where the underlying causes were oncological, is
consistent with the analysis of excess deaths.
We observe that in 2020 and 2021 the fraction
of malignant neoplasm deaths relative to all other
causes did not deviate significantly from the 2010-
2019 trend. We also show that in 2022, the rise
for disability claims was of similar magnitude in
percentage terms to the rise in excess adjusted death
rates.
Table 1 summarizes the yearly excess PIP claims
for oncological causes and compares them with the
equivalent numbers of excess deaths. In terms of
the absolute number of deaths from malignant neo-
plasms, in 2020, malignant neoplasm deaths were
about 2765, 38.8 less than the extrapolated 2010-
2019 trend. In 2021, there were about 3143 deaths
(374.4 more than the extrapolated trend), and in
2022, 3939 deaths, which is 1187 more than the
2010-2019 trend.
The results shown in Table 1 indicate that there
was a significant rise in both disability claims and
deaths due to malignant neoplasms for the 15-44
age group in the UK. Disabilities seem to only
have started increasing in 2022, with no apparent
rise in 2021, while excess deaths from malignant
neoplasms were already recorded. This could be
explained by delays in cancer clearances within the
PIP system. In 2022 the relative deviation from
baseline in disabilities was 39.4% while for deaths
it was 43.1%, both being similar in magnitude cor-
roborating that a common underlying phenomenon
is likely present.
We also observe that the absolute change in disa-
bilities was more than double the equivalent rises
in deaths, which points towards the risk of higher
malignant neoplasm deaths in the coming years if
these conditions are not cured.
ResearchGate PrePrint 15
UK - Death and Disability Trends for Malignant Neoplasms, Ages 15-44
2020 2021 2022
PIP Clearances N = 5,574 N = 5,474 N = 7,636
Deviation from 2015-2019 average (+96) (-4) (+2,158)
(+1.7%) (-0.1%) (+39.4%)
(Z = 17.9)
Adjusted malignant neoplasm Deaths N = 2,765 N = 3,143 N = 3,939
Deviation from 2015-2019 average (-38.8) (+374.4) (+1,187)
(-1.4%) (+13.5%) (+43.1%)
(Z = 5.1) (Z = 16.1)
Table 1. Summary for excess deaths and disabilities for malignant neoplasms in England and Wales
(deaths) and the UK (PIP claims).
We are currently in the process of pursuing fur-
ther investigations into this issue in more detail. In
particular, we will analyze the trends in deaths and
disabilities for the most common individual ICD-10
causes within malignant neoplasms, to gain insights
into the underlying phenomenon of action.
CONFLICT OF INTEREST STATEMENT
The authors declare that the research was condu-
cted in the absence of any commercial or financial
relationships that could be construed as a potential
conflict of interest.
ACKNOWLEDGEMENTS
The authors would like to acknowledge Elizabeth
Walsh, David Wiseman, Spiro Pantazatos, Herve
Seligmann and Norman Fenton for their feedback
on the manuscript.
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UK - Death and Disability Trends for Malignant Neoplasms, Ages 15-44
7 ANNEX
Table 2 ICD-10 Code List for Malignant Neoplasms (C00-C99).
ICD-10 Code Cause
C00 Malignant neoplasm of lip
C01 Malignant neoplasm of base of tongue
C02 Malignant neoplasm of other and unspecified parts of tongue
C03 Malignant neoplasm of gum
C04 Malignant neoplasm of floor of mouth
C05 Malignant neoplasm of palate
C06 Malignant neoplasm of other and unspecified parts of mouth
C07 Malignant neoplasm of parotid gland
C08 Malignant neoplasm of other and unspecified major salivary glands
C09 Malignant neoplasm of tonsil
C10 Malignant neoplasm of oropharynx
C11 Malignant neoplasm of nasopharynx
C12 Malignant neoplasm of pyriform sinus
C13 Malignant neoplasm of hypopharynx
C14 Malignant neoplasm of other and ill-defined sites
C15 Malignant neoplasm of esophagus
C16 Malignant neoplasm of stomach
C17 Malignant neoplasm of small intestine
C18 Malignant neoplasm of colon
C19 Malignant neoplasm of rectosigmoid junction
C20 Malignant neoplasm of rectum
C21 Malignant neoplasm of anus and anal canal
C22 Malignant neoplasm of liver and intrahepatic bile ducts
C23 Malignant neoplasm of gallbladder
C24 Malignant neoplasm of other and unspecified parts of biliary tract
C25 Malignant neoplasm of pancreas
C26 Malignant neoplasm of other and ill-defined digestive organs
C27 Malignant neoplasms
C28 Malignant neoplasms
C29 Malignant neoplasms
C30 Malignant neoplasm of nasal cavity and middle ear
C31 Malignant neoplasm of accessory sinuses
C32 Malignant neoplasm of larynx
C33 Malignant neoplasm of trachea
C34 Malignant neoplasm of bronchus and lung
C35 Malignant neoplasms
C36 Malignant neoplasms
C37 Malignant neoplasm of thymus
C38 Malignant neoplasm of heart, mediastinum, and pleura
C39 Malignant neoplasm of other and ill-defined sites in the respiratory system and intrathoracic organs
Continued on next page
ResearchGate PrePrint 18
UK - Death and Disability Trends for Malignant Neoplasms, Ages 15-44
Table 2 – Continued from previous page
ICD-10 Code Cause
C40 Malignant neoplasm of bone and articular cartilage of limbs
C41 Malignant neoplasm of bone and articular cartilage of other and unspecified sites
C42 Malignant neoplasms
C43 Malignant melanoma of skin
C44 Other and unspecified malignant neoplasm of skin
C45 Mesothelioma
C46 Kaposi’s sarcoma
C47 Malignant neoplasm of peripheral nerves and autonomic nervous system
C48 Malignant neoplasm of retroperitoneum and peritoneum
C49 Malignant neoplasm of other connective and soft tissue
C4A Merkel cell carcinoma
C50 Malignant neoplasm of breast
C51 Malignant neoplasm of vulva
C52 Malignant neoplasm of vagina
C53 Malignant neoplasm of cervix uteri
C54 Malignant neoplasm of corpus uteri
C55 Malignant neoplasm of uterus, part unspecified
C56 Malignant neoplasm of ovary
C57 Malignant neoplasm of other and unspecified female genital organs
C58 Malignant neoplasm of placenta
C59 Malignant neoplasms
C60 Malignant neoplasm of penis
C61 Malignant neoplasm of prostate
C62 Malignant neoplasm of testis
C63 Malignant neoplasm of other and unspecified male genital organs
C64 Malignant neoplasm of kidney, except renal pelvis
C65 Malignant neoplasm of renal pelvis
C66 Malignant neoplasm of ureter
C67 Malignant neoplasm of bladder
C68 Malignant neoplasm of other and unspecified urinary organs
C69 Malignant neoplasm of eye and adnexa
C70 Malignant neoplasm of meninges
C71 Malignant neoplasm of brain
C72 Malignant neoplasm of spinal cord, cranial nerves and other parts of central nervous system
C73 Malignant neoplasm of thyroid gland
C74 Malignant neoplasm of adrenal gland
C75 Malignant neoplasm of other endocrine glands and related structures
C76 Malignant neoplasm of other and ill-defined sites
C77 Secondary and unspecified malignant neoplasm of lymph nodes
C78 Secondary malignant neoplasm of respiratory and digestive organs
C79 Secondary malignant neoplasm of other and unspecified sites
C7A Malignant neuroendocrine tumors
Continued on next page
ResearchGate PrePrint 19
UK - Death and Disability Trends for Malignant Neoplasms, Ages 15-44
Table 2 – Continued from previous page
ICD-10 Code Cause
C7B Secondary neuroendocrine tumors
C80 Malignant neoplasm without specification of site
C81 Hodgkin lymphoma
C82 Follicular lymphoma
C83 Non-follicular lymphoma
C84 Mature T/NK-cell lymphomas
C85 Other specified and unspecified types of non-Hodgkin lymphoma
C86 Other specified types of T/NK-cell lymphoma
C87 of which malignant neoplasm of lymph/haematopoietic tissue
C88 Malignant immunoproliferative diseases and certain other B-cell lymphomas
C89 of which malignant neoplasm of lymph/haematopoietic tissue
C90 Multiple myeloma and malignant plasma cell neoplasms
C91 Lymphoid leukemia
C92 Myeloid leukemia
C93 Monocytic leukemia
C94 Other leukemias of specified cell type
C95 Leukemia of unspecified cell type
C96 Other and unspecified malignant neoplasms of lymphoid, hematopoietic and related tissue
C97 Malignant neoplasms
ResearchGate PrePrint 20