Insulin-like growth factor physiology and cancer risk

In the past few years, both laboratory investigations and population studies have provided strong circumstantial evidence that insulin-like growth factor (IGF) physiology influences cancer risk. In contrast to the influence of germ line mutations that are rare but are associated with very high risks, the impact of inter-individual variability in IGF physiology on risk appears to be modest but to effect a relatively high percentage of the population. Although this field of investigation is young, attention is already being given to the possibility that it may be relevant to clinical assessment of risk and/or to the identification of novel prevention strategies and intermediate endpoints. This review summarises key results in this field and provides a hypothesis concerning the mechanism by which IGF physiology influences risk of common epithelial cancers including those of breast, prostate, lung and colon.