Anne Wojcicki

Bryan, you’re right that for someone measuring hundreds of biomarkers a month, the genome adds less on the cardiometabolic side. But you’re an outlier. Most people don’t want to test themselves continuously, and most can’t. Even for you, your genome answers questions your biomarkers can’t. Blood work shows where you are now, not what’s coming. If you carried a BRCA2 variant, your prostate cancer risk would be meaningfully higher, often with earlier onset and faster progression. No panel flags that risk, but it changes when you start screening and how often. And most people with harmful variants in genes like BRCA1 and BRCA2 are not aware that they have them. There are also new and impactful discoveries still being made from the genome. We recently published a Science paper with Dana Farber on our discovery of an EGFR variant that increases lung cancer risk by 25x - far more than smoking history does (~3.8x). Lung screening guidelines are based on smoking history, so carriers go unnoticed unless someone reads their genome. The negatives matter just as much. Knowing you don’t carry a high-risk variant is information too. It enables you to know you don’t need increased screening beyond what guidelines recommend. Your APOE result counts even though it didn’t change your protocol, because it ruled something out. The genome also answers questions that go beyond your own health. For anyone planning to have kids, carrier screening shows whether both parents carry a recessive variant for a heritable condition like cystic fibrosis or spinal muscular atrophy. It’s an answer you want before a pregnancy, not after, and learning you’re not a carrier is just as valuable. This isn’t niche. On Friday at the American Society of Human Genetics (ASHG), Dr. Noura Abul-Husn presents data on ~6M people who got 23andMe health reports. More than 1 in 10 (660K+) had a medically actionable result linked to a health risk with established screening or prevention guidelines. These results change how people understand their personal health risks and empower them (and their doctors) to take action to stay healthy. Your genome isn’t a daily dashboard. It tells you which dashboard to build, and where to focus your attention.