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Cancer-associated thrombosis (CAT) is common and associated with mortality. We estimated CAT rate by cancer sites and inherited factors among cancer patients from the UK Biobank (N =70,406). The 12-month CAT rate after cancer diagnosis was 2.37% overall but varied considerably among cancer sites. Among the 10 cancer sites classified as 'high-risk' of CAT by the National Comprehensive Cancer Network guidelines, 6 had CAT rate <5%. In contrast, 5 cancer sites classified as 'average-risk' by the guidelines had CAT rate >5%. For inherited risk factors, both known mutation carriers in two genes (F5/F2) and polygenic score for venous thromboembolism (VTE) (PGS VTE) were independently associated with increased CAT risk. While F5/F2 identified 6% patients with high genetic-risk for CAT, adding PGS VTE identified 13 % patients at equivalent/higher genetic-risk to CAT than that of F5/F2 mutations. Findings from this large prospective study, if confirmed, provide critical data to update guidelines for CAT risk assessment. • Cancer-associated thrombosis (CAT) is common; its rate differs by cancer site and genetic factor. • CAT rates by cancer site and inherited factor were estimated in a large population-based cohort. • Cancer sites that are at increased risk for CAT differ considerably from current guidelines. • Both polygenic score and known mutations in F5 / F2 genes are associated with CAT risk. • Polygenic score and F5 / F2 gene mutations can identify 13% cancer patients at increased risk for CAT. [ABSTRACT FROM AUTHOR]