INS and cancer: Nutrient−sensing mTOR and insulin-growth-factor pathways, once dysregulated, hasten thymic involution and bias hematopoiesis toward myeloid lineages, shortening telomeres and constricting naïve-T-cell pools.20–22 The result is an older immune phenotype emerging decades earlier, plausibly amplifying cancer risk in exposed elders-as reflected by the age-stratified effect modification we observed.