IGF1 and diabetes mellitus: This finding aligns with previous studies demonstrating a higher risk of CRC occurrence with increased fat intake, contrasting with the protective effects of a diet rich in fruits and vegetables.[28] Diabetes, regardless of BMI, physical activity, or smoking status, is identified as a risk factor for colorectal cancer.[29,30] The underlying pathophysiological mechanism involves elevated serum levels of insulin and IGF-1, which promote the proliferation of colorectal epithelial cells.[31]