Analysis of risk factors for VTE during the 6-month period following cancer diagnosis
| . | SHR (95% CI) . | Adjusted SHR* (95% CI) . | Cumulative incidence (95% CI) . |
|---|---|---|---|
| Sex | |||
| Female | Ref | Ref | 1.61 (1.56-1.66) |
| Male | 1.11 (1.06-1.16) | 1.02 (0.98-1.07) | 1.78 (1.73-1.83) |
| Age group, y | |||
| <50 | Ref | Ref | 1.22 (1.13-1.31) |
| 50-59 | 1.37 (1.24-1.50) | 1.15 (1.04-1.26) | 1.66 (1.57-1.75) |
| 60-69 | 1.58 (1.45-1.72) | 1.24 (1.14-1.35) | 1.91 (1.84-1.99) |
| 70-79 | 1.56 (1.43-1.70) | 1.11 (1.02-1.22) | 1.89 (1.82-1.96) |
| ≥80 | 1.10 (1.00-1.22) | 0.75 (0.68-0.83) | 1.34 (1.26-1.42) |
| Prior VTE | |||
| No | Ref | Ref | 1.38 (1.35-1.42) |
| Yes | 8.10 (7.68-8.54) | 7.58 (7.18-8.01) | 10.46 (10.01-10.93) |
| Cancer stage at diagnosis† | |||
| Localized | Ref | Ref | 0.80 (0.75-0.84) |
| Regional | 2.44 (2.28-2.61) | 2.29 (2.14-2.45) | 1.93 (1.85-2.01) |
| Distant | 4.01 (3.76-4.28) | 3.15 (2.94-3.37) | 3.14 (3.03-3.25) |
| Cancer treatment‡ | |||
| No treatment | Ref | Ref | 1.05 (0.98-1.13) |
| Hormone therapy | 0.87 (0.76-0.99) | 1.18 (0.99-1.41) | 0.92 (0.82-1.03) |
| Surgery | 1.75 (1.62-1.89) | 2.20 (2.02-2.39) | 1.84 (1.79-1.90) |
| Radiotherapy | 1.96 (1.79-2.14) | 2.16 (1.94-2.39) | 2.07 (1.96-2.18) |
| Chemotherapy | 3.33 (3.08-3.60) | 3.35 (3.06-3.66) | 3.50 (3.39-3.61) |
| Targeted therapy | 3.97 (3.60-4.38) | 3.85 (3.43-4.32) | 4.18 (3.91-4.46) |
| Protein kinase inhibitors | 5.40 (4.58-6.38) | 4.07 (3.39-4.90) | 5.69 (4.89-6.56) |
| Antiangiogenic therapy | 5.67 (4.96-6.50) | 4.43 (3.76-5.22) | 5.93 (5.29-6.62) |
| VEGF inhibitors | 5.87 (5.04-6.84) | 4.29 (3.54-5.19) | 6.13 (5.35-6.98) |
| Immunotherapy | 3.84 (3.00-4.91) | 3.56 (2.75-4.59) | 4.08 (3.21-5.10) |
| Checkpoint inhibitors | 3.73 (2.16-6.43) | 2.78 (1.61-4.80) | 4.08 (2.27-6.71) |
| Other targeted therapy | 3.29 (2.93-3.70) | 3.48 (3.03-3.98) | 3.47 (3.17-3.79) |
| Charlson Comorbidity Index | |||
| 0 | Ref | Ref | 1.69 (1.65-1.74) |
| 1 | 1.02 (0.96-1.08) | 0.85 (0.80-0.90) | 1.72 (1.63-1.81) |
| 2 | 0.92 (0.82-1.03) | 0.70 (0.62-0.78) | 1.55 (1.39-1.73) |
| 3+ | 1.03 (0.87-1.23) | 0.68 (0.57-0.81) | 1.75 (1.47-2.06) |
| Cancer type | |||
| Melanoma | Ref | Ref | 0.36 (0.30-0.43) |
| Breast | 1.79 (1.46-2.19) | 1.53 (1.25-1.88) | 0.64 (0.59-0.70) |
| Testicular | 2.22 (1.58-3.12) | 2.17 (1.54-3.06) | 0.80 (0.60-1.05) |
| Prostate | 2.22 (1.81-2.71) | 1.86 (1.51-2.29) | 0.80 (0.73-0.87) |
| Leukemia | 3.55 (2.82-4.49) | 2.79 (2.19-3.55) | 1.27 (1.10-1.47) |
| Uterine | 4.01 (3.18-5.05) | 3.64 (2.88-4.60) | 1.43 (1.24-1.65) |
| Cervical | 4.17 (3.22-5.40) | 3.53 (2.72-4.58) | 1.49 (1.24-1.79) |
| Bladder | 4.63 (3.72-5.77) | 3.62 (2.89-4.53) | 1.66 (1.47-1.87) |
| Small-cell lung cancer | 4.17 (3.29-5.29) | 2.08 (1.63-2.65) | 1.50 (1.29-1.73) |
| Rectal | 5.78 (4.72-7.07) | 4.07 (3.31-5.01) | 2.07 (1.90-2.25) |
| Kidney | 6.11 (4.90-7.61) | 4.11 (3.29-5.14) | 2.17 (1.92-2.44) |
| Colon | 6.20 (5.11-7.52) | 4.06 (3.33-4.96) | 2.21 (2.09-2.34) |
| Brain | 6.09 (4.82-7.69) | 7.49 (5.91-9.48) | 2.18 (1.88-2.51) |
| Esophageal | 6.05 (4.78-7.67) | 3.45 (2.70-4.40) | 2.16 (1.86-2.50) |
| Non-Hodgkin | 7.44 (6.07-9.13) | 4.75 (3.85-5.85) | 2.66 (2.43-2.90) |
| Hodgkin | 8.05 (5.98-10.83) | 5.70 (4.23-7.70) | 2.88 (2.27-3.61) |
| Stomach | 6.96 (5.58-8.68) | 4.27 (3.40-5.36) | 2.48 (2.19-2.80) |
| Multiple myeloma | 7.96 (6.30-10.04) | 5.92 (4.65-7.53) | 2.84 (2.46-3.26) |
| Non–small cell lung cancer | 7.32 (6.05-8.85) | 4.03 (3.31-4.91) | 2.60 (2.48-2.73) |
| Ovarian | 8.75 (7.07-10.84) | 5.25 (4.22-6.54) | 3.10 (2.78-3.44) |
| Biliary | 8.16 (6.10-10.92) | 5.05 (3.75-6.80) | 2.90 (2.31-3.60) |
| Liver | 7.98 (6.29-10.12) | 4.50 (3.53-5.75) | 2.82 (2.42-3.26) |
| Pancreatic | 12.64 (10.37-15.41) | 6.38 (5.19-7.84) | 4.43 (4.12-4.76) |
| . | SHR (95% CI) . | Adjusted SHR* (95% CI) . | Cumulative incidence (95% CI) . |
|---|---|---|---|
| Sex | |||
| Female | Ref | Ref | 1.61 (1.56-1.66) |
| Male | 1.11 (1.06-1.16) | 1.02 (0.98-1.07) | 1.78 (1.73-1.83) |
| Age group, y | |||
| <50 | Ref | Ref | 1.22 (1.13-1.31) |
| 50-59 | 1.37 (1.24-1.50) | 1.15 (1.04-1.26) | 1.66 (1.57-1.75) |
| 60-69 | 1.58 (1.45-1.72) | 1.24 (1.14-1.35) | 1.91 (1.84-1.99) |
| 70-79 | 1.56 (1.43-1.70) | 1.11 (1.02-1.22) | 1.89 (1.82-1.96) |
| ≥80 | 1.10 (1.00-1.22) | 0.75 (0.68-0.83) | 1.34 (1.26-1.42) |
| Prior VTE | |||
| No | Ref | Ref | 1.38 (1.35-1.42) |
| Yes | 8.10 (7.68-8.54) | 7.58 (7.18-8.01) | 10.46 (10.01-10.93) |
| Cancer stage at diagnosis† | |||
| Localized | Ref | Ref | 0.80 (0.75-0.84) |
| Regional | 2.44 (2.28-2.61) | 2.29 (2.14-2.45) | 1.93 (1.85-2.01) |
| Distant | 4.01 (3.76-4.28) | 3.15 (2.94-3.37) | 3.14 (3.03-3.25) |
| Cancer treatment‡ | |||
| No treatment | Ref | Ref | 1.05 (0.98-1.13) |
| Hormone therapy | 0.87 (0.76-0.99) | 1.18 (0.99-1.41) | 0.92 (0.82-1.03) |
| Surgery | 1.75 (1.62-1.89) | 2.20 (2.02-2.39) | 1.84 (1.79-1.90) |
| Radiotherapy | 1.96 (1.79-2.14) | 2.16 (1.94-2.39) | 2.07 (1.96-2.18) |
| Chemotherapy | 3.33 (3.08-3.60) | 3.35 (3.06-3.66) | 3.50 (3.39-3.61) |
| Targeted therapy | 3.97 (3.60-4.38) | 3.85 (3.43-4.32) | 4.18 (3.91-4.46) |
| Protein kinase inhibitors | 5.40 (4.58-6.38) | 4.07 (3.39-4.90) | 5.69 (4.89-6.56) |
| Antiangiogenic therapy | 5.67 (4.96-6.50) | 4.43 (3.76-5.22) | 5.93 (5.29-6.62) |
| VEGF inhibitors | 5.87 (5.04-6.84) | 4.29 (3.54-5.19) | 6.13 (5.35-6.98) |
| Immunotherapy | 3.84 (3.00-4.91) | 3.56 (2.75-4.59) | 4.08 (3.21-5.10) |
| Checkpoint inhibitors | 3.73 (2.16-6.43) | 2.78 (1.61-4.80) | 4.08 (2.27-6.71) |
| Other targeted therapy | 3.29 (2.93-3.70) | 3.48 (3.03-3.98) | 3.47 (3.17-3.79) |
| Charlson Comorbidity Index | |||
| 0 | Ref | Ref | 1.69 (1.65-1.74) |
| 1 | 1.02 (0.96-1.08) | 0.85 (0.80-0.90) | 1.72 (1.63-1.81) |
| 2 | 0.92 (0.82-1.03) | 0.70 (0.62-0.78) | 1.55 (1.39-1.73) |
| 3+ | 1.03 (0.87-1.23) | 0.68 (0.57-0.81) | 1.75 (1.47-2.06) |
| Cancer type | |||
| Melanoma | Ref | Ref | 0.36 (0.30-0.43) |
| Breast | 1.79 (1.46-2.19) | 1.53 (1.25-1.88) | 0.64 (0.59-0.70) |
| Testicular | 2.22 (1.58-3.12) | 2.17 (1.54-3.06) | 0.80 (0.60-1.05) |
| Prostate | 2.22 (1.81-2.71) | 1.86 (1.51-2.29) | 0.80 (0.73-0.87) |
| Leukemia | 3.55 (2.82-4.49) | 2.79 (2.19-3.55) | 1.27 (1.10-1.47) |
| Uterine | 4.01 (3.18-5.05) | 3.64 (2.88-4.60) | 1.43 (1.24-1.65) |
| Cervical | 4.17 (3.22-5.40) | 3.53 (2.72-4.58) | 1.49 (1.24-1.79) |
| Bladder | 4.63 (3.72-5.77) | 3.62 (2.89-4.53) | 1.66 (1.47-1.87) |
| Small-cell lung cancer | 4.17 (3.29-5.29) | 2.08 (1.63-2.65) | 1.50 (1.29-1.73) |
| Rectal | 5.78 (4.72-7.07) | 4.07 (3.31-5.01) | 2.07 (1.90-2.25) |
| Kidney | 6.11 (4.90-7.61) | 4.11 (3.29-5.14) | 2.17 (1.92-2.44) |
| Colon | 6.20 (5.11-7.52) | 4.06 (3.33-4.96) | 2.21 (2.09-2.34) |
| Brain | 6.09 (4.82-7.69) | 7.49 (5.91-9.48) | 2.18 (1.88-2.51) |
| Esophageal | 6.05 (4.78-7.67) | 3.45 (2.70-4.40) | 2.16 (1.86-2.50) |
| Non-Hodgkin | 7.44 (6.07-9.13) | 4.75 (3.85-5.85) | 2.66 (2.43-2.90) |
| Hodgkin | 8.05 (5.98-10.83) | 5.70 (4.23-7.70) | 2.88 (2.27-3.61) |
| Stomach | 6.96 (5.58-8.68) | 4.27 (3.40-5.36) | 2.48 (2.19-2.80) |
| Multiple myeloma | 7.96 (6.30-10.04) | 5.92 (4.65-7.53) | 2.84 (2.46-3.26) |
| Non–small cell lung cancer | 7.32 (6.05-8.85) | 4.03 (3.31-4.91) | 2.60 (2.48-2.73) |
| Ovarian | 8.75 (7.07-10.84) | 5.25 (4.22-6.54) | 3.10 (2.78-3.44) |
| Biliary | 8.16 (6.10-10.92) | 5.05 (3.75-6.80) | 2.90 (2.31-3.60) |
| Liver | 7.98 (6.29-10.12) | 4.50 (3.53-5.75) | 2.82 (2.42-3.26) |
| Pancreatic | 12.64 (10.37-15.41) | 6.38 (5.19-7.84) | 4.43 (4.12-4.76) |
Ref, reference group; VEGF, vascular endothelial growth factor.
Adjusted for age, sex, prior VTE, cancer stage (solid cancers), cancer type (categorized for VTE risk according to Khorana score classification).
For solid cancers and lymphoma.
Treatments received during the first 4 months after cancer diagnosis. Treatments were not mutually exclusive. Targeted therapies could only be evaluated from 2004 onward.