A new study from Weill Cornell Medicine-Qatar (WCM-Q), a member of Qatar Foundation, is drawing global attention for its investigation into how insulin resistance (InsR) may contribute to the rising incidence of early-onset colorectal cancer (EOCRC) in people under 50. Published in Cancer Cell in May 2025, the article titled “Complexity of Insulin Resistance in Early-Onset Colorectal Cancer” explores biological, environmental, and lifestyle drivers of the disease — with special relevance to health trends in the Gulf region.

Why This Research Now?

Colorectal cancer used to be a disease of older age. But in recent years, clinicians and public health experts have seen a concerning spike in cases among younger adults, often without family history or classic risk factors. Between 1990 and 2019, early deaths from GI cancers rose by nearly 28% globally.

This rise, seen in Qatar and across the Gulf, parallels a broader increase in metabolic disorders — including obesity, Type 2 diabetes, and prediabetic insulin resistance — especially in younger populations.

According to the authors, “Insulin resistance has the potential to alter cell proliferation, inhibit apoptosis, and shape a pro-carcinogenic environment in the colon and beyond.”

WCM-Q’s Mission: Tackling Qatar’s Health Priorities

The study supports WCM-Q’s broader mission to confront diseases of local and regional importance — from metabolic syndrome to cancers linked to diet and lifestyle.

The commentary article is co-authored by senior researchers Dr. Samson Mathews Samuel, Dr. Elizabeth Varghese, and Prof. Dietrich Büsselberg. Although it is not an original clinical trial, it synthesizes existing evidence and proposes new hypotheses, positioning Qatar as a thought leader in EOCRC research.

Key Takeaways: How Insulin Resistance May Fuel EOCRC

1. Lifestyle and Behavioral Factors

Sedentary behavior, poor diet, disrupted sleep, tobacco use, and psychological stress all promote insulin resistance, creating an environment ripe for tumor development.

2. Gut Microbiome Disruption

Early antibiotic use, high-fat/low-fiber diets, and chronic stress can destabilise the gut microbiota — which plays a major role in both metabolism and colon cancer risk.

3. Early Environmental Exposures (Exposome)

The researchers point to the “exposome” — early-life exposures to chemicals, medications, or metabolic insults — as a likely contributor to long-term insulin dysregulation and inflammation.

This broader systems-based model suggests EOCRC is not simply random — but the downstream result of long-term metabolic and immune disruption.
From Academic Insight to Public Action

The project was funded by Qatar National Research Fund (QNRF) under NPRP grant number NPRP14S 0311 210033, and builds on collaborative data from Hamad Medical Corporation and Qatar University. Two new proposals have been submitted to the QRDI PPM08 call to expand the study using Qatar’s unique genomic and public health data.

Cultivating Future Scientists

While the article was authored by senior faculty, the research is embedded within a broader strategy to empower young Qatari scientists and physician-researchers. Students including Dr. Noujoud Al-Ansari, Raghad Ibrahim, Shahd Ibrahim, and Ruqayyah Shahiduzzaman have contributed to parallel studies and are preparing manuscripts on the epigenetics of EOCRC and insulin pathways.

This reflects WCM-Q’s long-term commitment to Qatarization of biomedical research and building local capacity in translational medicine.
The Road Ahead: from Science to Policy

Dr Varghese explains the vision forward:

“We are now in the era of precision public health. If we understand who is metabolically vulnerable by age 25, we can prevent cancer by age 45.”

The research team is now focusing on identifying biomarkers of early tumorigenesis in patients with metabolic disorders — including colorectal, pancreatic, and breast cancers.

They’re leveraging WCM-Q’s state-of-the-art facilities in:
  • Genomics & Proteomics
  • Metabolomics & Microbiome Analysis
  • Bioinformatics & Molecular Imaging
  • Policy and Public Health Implications

This study carries several key implications:
  • Screening Guidelines
Current colorectal screening starts at 45–50. This research calls for earlier screening in populations with insulin resistance or metabolic syndrome — even in their 30s.
  • Public Awareness Campaigns
WCM-Q and Qatar Foundation are preparing culturally tailored educational initiatives targeting young adults, to raise awareness about the hidden metabolic roots of cancer.
  • Preventive Pharmacology
The article highlights research into agents like metformin, aspirin, and statins, which show promise in reducing cancer risk in insulin-resistant individuals.
Translating Research Into Impact.

Qatar’s healthcare and research ecosystem is uniquely positioned to apply this insight:
  • Genetic Screening + Lifestyle Counselling
  • Data-driven Stratification of Risk
  • Targeted Prevention in Primary Care
This integrated model aligns with Qatar’s National Health Strategy, which prioritises early detection and lifestyle-based interventions for NCDs and cancer.
Conclusion: A Call to Action

The message is clear: early-onset colorectal cancer is not an accident of youth, but potentially the result of metabolic misfires that begin years earlier. Insulin resistance may be the “missing link” in understanding the cancer epidemic among young adults.

Through this landmark research, Qatar positions itself at the cutting edge of metabolism-oncology research, driving global conversations about precision medicine and population health.

Citation:
“Complexity of Insulin Resistance in Early-Onset Colorectal Cancer”
Authors: Samson Mathews Samuel, Elizabeth Varghese, Dietrich Büsselberg
Department of Physiology and Biophysics, Weill Cornell Medicine–Qatar
Corresponding authors
Published in Cancer Cell, May 2025
PubMed: 40250447