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These exclusions are not formalities: the growth hormone and IGF-1 axis is directly involved in cell proliferation, and higher circulating IGF-1 has been associated with increased breast and prostate cancer risk in large cohort data (a Journal of Clinical Endocrinology and Metabolism cohort study of more than seven thousand people linking higher IGF-1 to increased breast and prostate cancer risk over a median follow-up beyond seventeen years), while growth hormone itself opposes insulin and can worsen glucose control (a Vitamins and Hormones review of growth hormone and glycemic metabolism describing how growth hormone opposes insulin and affects glucose handling)