[MUSIC PLAYING]
JONATHAN ROSENBERG:
I'm Jonathan Rosenberg,
and I ran product management
here for 10 years.
And I don't usually come
and introduce speakers.
But Anne is special.
And so I came to tell you why.
Since 2002, when
I joined Google,
my favorite days were Mondays.
For 10 years, Monday morning was
Eric and Larry's staff meeting.
And I was surrounded
by smart people
with a mission that mattered.
And in the afternoon, I
would run my staff meeting.
And my staff meeting was Sundar,
and [INAUDIBLE] and Marissa,
and the second smartest
was [INAUDIBLE]..
Is this being recorded?
Susan, I love you.
And in 2011, when all of
that ended and I moved out
of an operational role,
I thought I'd never
have exciting Mondays again.
Then Susan introduced
me to Anne.
And I started going to
23andMe's staff meeting
and helping over there.
So now on Mondays, once again,
I'm surrounded by smart people,
and I'm in a company
where the mission matters,
bringing personalized
medicine to make us healthier.
We care about being healthier.
So the mission is terrific.
The team is brilliant.
It's a little bit different
because more than half
of the faces in
the room are women.
And the CEO's a woman.
And Katie and Jessica are
here, some of the people
who are in the staff meeting.
In fact, more than half
of the faces in the room
are women, even when I'm there.
We're doing pretty well.
So rather than go
through all the yada
yada of a traditional
introduction, you know,
like Anne is special,
and she went to Yale,
and she spent 10 years doing,
like, medicine, and health care
investing--
Anne is very googly.
Look at the way she's
dressed for her Google talk.
[LAUGHTER]
So listen to Anne.
Listen to her vision.
Listen to Anne and
Jordan talk about some
of the great
challenges that she's
faced building 23andMe and
many of the googly values
that she's infused in
this wonderful company.
And Anne, you're
the reason I get out
of bed on Monday mornings.
I love you.
[APPLAUSE]
OK, I'll turn things
over to Anne and Jordan.
JORDAN THIBODEAU: All right.
Can you guys hear me?
OK.
Thank you for joining us here.
I really appreciate it.
Anne, thank you for joining us.
ANNE WOJCICKI: Of course,
after an intro like that.
Right?
JORDAN THIBODEAU: I know.
You can't beat that.
So for the first
45, 50 minutes, I'm
going to go with questions
that I took from Dory.
So thank you all for
so many Dory questions.
And then for last
10 minutes, we'll
do a mixture of live
questions and Dory questions.
But I wanted to start off
first with your relationship
here with Google and your
story that you were telling me
about you in the cafe.
ANNE WOJCICKI: Yeah.
So obviously, I've known Google
since the very earliest days.
It started in my
sister's garage.
So it was one of those
things in the early days.
We'd be doing dishes, and we
could see Sergei and Larry
coding in the other bedroom.
And I always used to say, I
was like, it's really weird
that you have these
guys just sitting
in the other room coding
while we're doing dishes.
It was really unusual.
So obviously, I've spent a
lot of time at the company.
And I was saying
how 23andMe used
to have an office on Shorebird,
so just around the corner.
And we're a startup.
We're scrappy.
And so it was very apparent
that Google had a lot of food.
So we used to make our way
over here, and back when there
were burritos right downstairs.
There was great burritos.
And so they're easy to carry.
So I would walk over
every other Thursday.
And we'd have
these team lunches.
And I'd just get,
like, 10 burritos.
And so I was walking out,
carrying all my burritos.
And I open the door, and I look.
And it's Eric Schmidt
and Steve Jobs.
And I was like,
oh, hi, you guys.
Like, what are you doing?
And Eric's like,
what are you up to?
I'm like, oh, just
getting lunch.
And Steve had just launched
the iPhone and was like,
have you seen the iPhone?
Do you see it?
I'm like, yeah.
Great!
So I've had a lot of
great experiences.
I'm obviously such a
huge fan of Google.
And in a lot of ways, it's had
a huge influence on 23andMe.
And I think a lot
of the values that I
saw, especially
in the early days,
have really influenced
how we've run the company.
JORDAN THIBODEAU: Now, you were
mentioning about your values
in 23andMe.
And you were telling me
about your relationship
with your grandmother and her
experience with the health care
system.
Can you talk a
little about that?
ANNE WOJCICKI: Yeah.
So as a background,
I used to invest
in health care companies.
And health care is a really
complicated industry.
And it's not necessarily
always doing the right thing
for the consumer.
And I used to always complain.
Actually, the last
hedge fund I was at
was a fund that we
nicknamed deathwatch.
And we used to just
short everything
because it's really easy to
predict failures in biotech,
but it's hard to
predict successes.
And so I was kind of just like
this really negative, like,
everything sucks in health care.
It's all bad.
It's all failing.
It's all about, how do I just
take advantage of the consumer?
And I remember Larry
turning to me one day.
And he's like, Anne, you're
either part of the solution
or you're part of the problem.
Right now, you're
part of the problem.
I was like, oh, that's true.
In some ways, it was a good slap
of like, when you see problems,
you need to do
something to change it.
And one thing that
we've always--
my family-- has always been
really passionate about is
health care.
And part of this came from
the fact that my mother was--
she was very poor growing up.
And she had a little brother.
And when he was
18 months old, he
got into a bottle
of aspirin, and he
ate that bottle of aspirin.
And he was clearly lethargic.
They took him from hospital
to hospital to hospital.
And my mom was five at the time.
And they were refused
treatment because they
couldn't show proof of payment.
They finally got some
hospital to take him.
And they took him.
And then when my grandmother
called in the morning,
they said he was dead.
And it had a huge
impact on my mom,
as it would have on any family.
And my mom at the
time was very clear.
If you don't take care
of yourself, no one will.
And you have to be responsible
for your health care.
So when I pulled my Kaiser
medical records at some point,
my sisters and I discovered
that our records actually
had an asterisk at
the top that said,
"As all of us in
Pediatrics know,
this mother can be very
irrational at times."
And as Jonathan has had some
lovely times also working
with my mom, my mom is a force,
and especially in health care.
We routinely get
fired from doctors.
We routinely are told people
don't want to work with us.
And I think one thing I've
learned is in some ways,
good health care comes
to those who complain.
And you have to be
really proactive.
So it was one those things.
We were always a super
proactive family,
understanding our health.
And it was one of
the things that I
think really bothered me when
I was investing in health care
is I realized how
much the system is not
set up for your success.
No one makes money--
if you live to be 100
and you never are sick,
no one makes money.
And health care
is 18% of our GDP.
Clearly, lots of
people are making money
off you being sick.
But it is a real problem.
And so a lot of my
passion for 23andMe,
when I started the company,
came from how much I said,
like, I want to do something
that's genuinely right,
that allows people to be
active in their health
and proactive the way my mother
has always been proactive
for me and that
she has taught me
to be proactive with my health.
JORDAN THIBODEAU: Can you
talk about the first years
of you building 23andMe, the
challenges you went through.
ANNE WOJCICKI: So we got lucky.
You know, I think a lot
of founders-- like Sergey
and Larry used to say this.
They got lucky.
They were at the right
place at the right time.
I happened to be-- when I
was investing on Wall Street,
I happened to realize
genetic information,
it was suddenly
cheap to get access
to a broad amount of
information on your genome.
And I was really
lucky noticing one,
suddenly, individuals could
get access to your genome.
And then there was this
whole convergence of Web 2.0.
There was going to
be social networks.
And you're going
to find each other.
And it was hot.
It was so interesting.
And it was MySpace.
And I suddenly realized that
one of the things that's
a big issue in health care
is there's a lack of data.
So routinely, my
sister, other sister,
does nutrition research.
And routinely, you
look at those studies,
and it's like 200
patients here, 200 here.
And my dad, who is a
particle physicist,
would be like, anyone who
knows about statistics
knows you can't find
anything in this.
You need lots of data.
And clearly, the
Google world had
taught me the value of lots
of data and what you can do.
So I got lucky with this idea
of, why do I need Stanford?
Why do I need Pfizer to go
and do all this research?
I can just allow
all these people
to learn about their genome.
It's so cool.
Learn about your genetics.
And then we're going to
bring everyone together
in this whole new
research model.
It's going to be
like crowdsourcing.
We're going to have
the world's data.
I don't need
Stanford, and Pfizer,
and all these other people.
I don't want you to
be a human subject.
I want it to be a live
participant, excited
in research.
So we had this idea
of really marrying
this idea of cool technology
with this concept of Web 2.0.
And we launched the company.
And initially, I
had this enthusiasm.
I think genetics are so cool.
I think there's nothing
cooler than the idea of like,
you have a genetic code.
Everyone in this room
is 99.5% the same.
Yet we clearly have
all this diversity.
And we don't understand it.
It's a code.
Like, how do people
sleep at night?
It's so interesting, and
we don't understand it.
And so I had this enthusiasm.
But I started to realize
that the rest of the world's
not quite as passionate
about genetics as I am.
And so we launched.
And we had this
big spit parties.
We had all kinds of press.
And then, we sold probably
1,000 kits the first day.
And then we were selling
like 15 to 20 kits a day.
And as everyone realizes,
15 to 20 kits a day
is not a lot of money.
That is not even going to be
a ramen profitable company.
That's rough.
So it made me realize,
we have to do a lot
to help people understand
what are genetics.
Most people, really smart
people, would come to me
and be like, oh, I don't
want to know my DNA.
I don't want to know the
day I'm going to die.
And I was like, if
I could tell you
the day you were going to die,
I'd charge you a lot more.
[LAUGHTER]
What are you, idiot?
Like, I-- [LAUGHS] I was
like, no, it's like risk.
And you realize most people
don't understand risk.
And so the thing that
I've been lucky with
is I have a team of people who
joined 23andMe because they're
really passionate.
And my love for science--
like I said, my father
is a particle physicist
and has kids.
My sisters and I grew
up always realizing--
we'd tell people, like, oh,
my dad, he studies neutrinos.
He's searching for mass.
And people were like, what?
What is he doing?
And I just realized in some
ways, it always bothered me.
I think physics is the most
beautiful science out there.
But most people
don't understand it.
And genetics is similar.
I really didn't want the fate
that my father went through
with physics of lack of
funding and all this.
I wanted the average individual
to see the beauty of DNA,
and see it within their own
lens, and capture this idea of,
we're all most
interested in ourselves,
and so your DNA is really
interesting to you.
So the people I hired in those
early days, a lot of them
are still the company.
And they're really
passionate about this idea
that you want people
to see that beauty.
And so I'm lucky
because the fact
that it was hard
those first years
and we didn't have huge
sales, it didn't deter people.
Because again, scientists
are used to failure.
Like, well, you know, we
just have to try this.
We have to try that.
We have to try other strategies.
So I'm lucky with that.
And also, the science,
one of the things
that we did with the
company that was unusual
is we weren't
excessively marketing
because we decided we
wanted to really make sure
that we had the
science down before we
did a lot of marketing.
And the one marketing
thing we did--
this is another funny story.
Sergey at this time--
I don't know who's
been here for how long.
Sergey was really interested
in Zeppelins, you know, blimps.
And so there was a
Zeppelin for a while.
And Sergey didn't want to
stick a Google sticker on it.
So he was like, I don't know.
You could put 23andMe on it.
Because he wanted to
sell advertising on it.
So we put a 23andMe
sticker on it.
And it got a lot of press that
there was a giant Zeppelin
flying around town.
TechCrunch had all
these articles.
So that was my one attempt
before we had a marketing team.
I had the blimp.
I'm no longer part of
the marketing team.
[LAUGHTER]
But we really
focused as a company,
too, in those early days.
We recognized we
have no business
if we don't have a
scientific foundation,
and that the core
of the company--
I needed to win
over the scientists,
and make sure that they
understand what we're doing,
and that they're
supportive of what we're
doing before I go big,
and start going on TV,
and start advertising.
And in some ways, that also
really benefited the company
because when there
was controversy,
I never had to
worry about my core.
I always knew the foundation of
the company was really strong.
I didn't have to worry.
I understood it
was misunderstood
in all these ways.
But scientifically,
I was always solid.
And I knew that.
JORDAN THIBODEAU: Excellent.
And when you proposed
the blimp idea,
did you have to bring it
up your board or something?
ANNE WOJCICKI: No.
I think-- I think I just did it.
That's the beauty of a
startup is you don't even
think about these things.
I don't know.
I just-- I just put it up there.
No.
I mean, my board has
always been pretty small.
And again, when you're
a 10-person company
or a 15-person company, you
just do things all the time
that are kind of crazy.
When we launched our
spit party in New York,
we had Barry Diller
host and Rupert Murdoch,
and all these people
host a spit party.
And it was on the cover of the
style section on the Sunday
style section.
And I remember people
like Eric Lander,
like serious
scientists, who were
like, it is so disrespectful
to have science on the style
section.
This is not appropriate!
And I was like, no, more
people read the style section
than they read science Tuesday.
This is great.
So we were always kind of doing
things that were a little bit
different.
Like, we wanted to do things--
not necessarily the blimp,
but the blimp was fun.
But we wanted to do
things that we're
going to be atypical of what
the traditional scientific world
does.
Because most people
are not out meeting
"New England Journal"
and "Science" magazine.
We want to bring
science to the masses.
JORDAN THIBODEAU: Excellent.
When I had Ben Horowitz here,
we talked about the struggle
that CEOs go through where it's
just a really challenging time,
and you have to really
fight through it to survive.
It seemed like the struggle for
you was during that whole FDA
period.
Can you talk to us
about that and then also
what kept you going
during that time?
ANNE WOJCICKI: I think I've had
two struggles in the company.
So the FDA one was
clearly an important one.
And in some ways, it
was the most public.
And it forced us to really
change our strategy.
What happened is
we got the letter.
We got the FDA warning
letter on a Friday.
And I was at a team offsite.
We were at a strategy offsite.
We were talking about like,
we have massive growth.
We were really excited.
We were going for
a million people.
And my assistant at
the time texted me.
And she said, you got
a special del-- like,
the FDA is trying to
courier something to you.
And I was like, well,
don't sign for it.
[LAUGHTER]
And she was like, I already did.
I was like, oh, why'd
you sign for it?
And then I was like,
bring it to me.
And then, we read it.
And we'd gotten a lot of
warning letters in the past.
We were kind of
used to it by then.
We were like, yeah,
you know, whatever,
we got them all the time.
But this one was a
lot more serious.
And to be honest,
Silicon Valley is not
known for its interaction
with regulators.
So I think we were
relatively naive.
I get this question a lot.
Were we just like so
arrogant that we'd kind of
given the finger to the FDA?
Or were we just incompetent?
And I think it's that
we were just uneducated.
It took me a while, even
after getting that letter--
because then it was made
public on Monday morning.
And people read it.
And they were like,
wow, this is probably
one of the most
serious warning letters
that's ever been put out there.
And it was actually one of
the former heads of the FDA
who called me and
was like, Anne,
they're not messing around.
You have to stop.
And it definitely halted
a lot within the company.
And that first week, I think
I just spent the entire week
in my pajamas calling lawyers.
I didn't move from my desk.
I just called.
And for me, I've always
been very data driven.
I just wanted all
the information.
So I was just
pulling information.
Like, what do I do?
And we've always
historically been really
good at finding loopholes.
So for instance, in New
York, where we were not
allowed to sell, we
discovered that it wasn't that
we weren't allowed to sell.
You just weren't allowed to
physically spit in the state.
And I was like, that's great.
People can spit in New Jersey.
And so we found kind
of this loophole.
Customers used to have to attest
that they had not physically
spat in the state.
[LAUGHTER]
And so I spent a lot
of time figuring out,
how do I work around this?
And to be honest, one
of the workarounds
today is that you put what we
call sort of a doc in the box.
You have a telemedicine doctor,
where you just can call.
It's just like they're
like on the back end.
You don't even
necessarily see it.
And they order it for you.
And when you have that,
you can kind of circumvent.
You can become a
laboratory developed test.
And there was one regulator
in particular who I met with.
And she goes, you know, Anne,
what you're trying to do
is fundamentally
really disruptive.
You're trying to
allow consumers to get
direct access to care
without having to go
through a medical provider.
And if you succeed in
that, you can really
have an impact, a real
positive impact on the system.
But doing that is
not a workaround.
It's hard work.
Either you decide you
want to put your head down
and you want to just
really get that work done,
or you find if you want
to sell this company
in a couple of years, like
you do this workaround
and you're just like whatever.
You're just
circumventing the system.
But you can change the system.
And that conversation
had a huge impact.
And I said, look, I'm
in it for the next--
I'm in it for life so I'm
willing to do the hard work.
And from that moment,
it was a couple of years
before we actually got
our first approval.
And the way we did it-- people
always ask like, what'd you do?
And in some ways, when
you're in a hole like that--
the regulators did not trust us.
And so the way that
you win back trust,
especially with an
organization like the FDA,
is they speak in data.
You guys probably
all work with people
who, they understand data.
Like, show us the data and
then we can make a decision.
And one the other things I
learned with the FDA too--
I always tell my kids this.
I learned obedience.
I learned that when
you go to the DMV,
you don't argue about
standing in line,
or you don't argue about
doing a vision test.
You just do it.
You don't try to say, oh,
I just had one last week.
Here's the report.
You just do it.
And similar to the FDA, you
have to recognize they sometimes
know more than you
do because they're
seeing the whole picture.
And you just do it.
You negotiate, but you do
what they ask you to do.
And in some ways, by showing
that we could be obedient,
and we could follow directions,
and that we had the data
to prove it--
and we had to change a lot
of things within the company
to be a regulated company.
And there's a lot that we had
to do from an engineering,
and product, and
design perspective
to document how
everything happens.
And so again, it's
been a ton of work,
but it's fundamentally made
us a much better company
because our processes
are much stronger.
So it definitely was rough.
And there was a
lot of controversy
within the company about whether
or not this was the right path.
And I think, as a
leader of the company,
one the most
important things to do
is to allow controversy, allow
people to voice their questions
and voice it.
I think that's one
thing I learned
with Google is like, you
want to let people debate.
Debate is really good.
But once you make a decision,
everyone is on board.
And if you don't agree, then
it's not the right place.
But we have a fair
amount of debate.
And I encourage
that as a leader.
I encourage that debate.
And then once we
make a decision,
and you can set a vision for
the future and say, look,
we're trying to fundamentally
change the system.
We're trying to
empower consumers.
My next thing, like, why do you
have to go and get a doctor's
order to get a blood test?
Do you always need it
for a prescription?
The whole patriarchal
system, like,
why do you need this physician
or medical involvement
before you can actually get
some of this information?
So we were really out
for that bigger picture
of trying to change the system.
JORDAN THIBODEAU: So of
your current offerings,
you offer the ancestry test, and
then you get the health test.
ANNE WOJCICKI: Correct.
So for two years, all we
did was offer ancestry.
And we focused on pulling
out the health information.
We have three FDA approvals
now, or authorizations.
So we have carrier status.
We have genetic, which is
things like cystic fibrosis.
We have genetic health
risks, which is things like
Parkinson's disease
and Alzheimer's.
And then we have now the breast
cancer variants, the three
most common in Jewish women,
or Jewish individuals,
that we test for those variants.
JORDAN THIBODEAU:
Are you planning
to offer more extensive testing,
such as metabolic imbalances
and enzymes?
ANNE WOJCICKI: Like what?
JORDAN THIBODEAU: Because
I have a Googler asking.
His family member
has chronic pain.
And--
ANNE WOJCICKI: I think--
so no.
I mean, we're focusing on DNA.
If it's a genetic variant of
a test that we could detect,
we're focusing just
on DNA right now.
So we definitely think
about partnerships
that we could do
that would have--
especially anything
that we could do that's
potentially at
home, where we could
allow you to have
at home collection
and think about other
tests that you're getting.
But right now,
it's just focused--
We're definitely looking
to expand the tests
that we're offering.
But everything will be
just based on genetics.
JORDAN THIBODEAU: Excellent.
So given the large
corpus of data
you're putting
together, how have
you been able to use
this for promoting cures
or new developments
in the field?
ANNE WOJCICKI: So that
was part of the hypothesis
of the company is that if I
collect all of this information
and all of this data, can I
then more effectively make
discoveries, academic research
discoveries, as well as,
can I translate this information
into drug therapeutics?
So the drug
industry-- again, when
I was investing in companies and
running that fund that I called
Deathwatch, part of the reason
why I could do something
like that is statistically, 90%
of everything fails in biotech.
So if 90% of everything fails,
you just short everything.
You don't have to do
that much math for it.
It was just like, you
can predict failures.
So in the drug
discovery business,
the pharma lobbying
group is the only group
I know that would actively
promote every year how
it's more and more
expensive to create a drug.
So when I started investing,
it was $700 million
to make a drug.
And today, it's
close to $3 billion.
So it's only getting worse.
So the idea with all this
data is, can I, in some ways,
more effectively use
this data to translate it
into drug hypotheses?
And then do I have
a higher success
rate for making therapeutics?
So we are doing that now.
We hired Richard Scheller,
who was the head of research
and development at Genentech.
We have over 10 programs
in development now.
We've been doing this
now for three years.
We work with a ton of
pharma partnerships.
So we are actively
trying to say,
can you turn data into
curative therapeutics?
So we are actively
working on that now.
And my hope is--
again, because we're
a scientific team,
I can say this is my hypothesis.
But I can't make any claims yet.
But my hope is in 10
years, I can come back
and say, look, here's
our success rate
compared to industry averages.
And we believe that
success rate will
come because we're starting
with something that's
data driven, based on genetics.
JORDAN THIBODEAU: Now, is that
possibly a new business model
for the users of 23andMe also?
Like, if I provide
you with health data,
it leads to some type of cure--
ANNE WOJCICKI: It's
hard to translate.
The reality with
drug development
is that drug development, it's
a really long and complicated
process.
So at what point in
time can I identify
that your participation
made such a huge difference?
So what we try to
do is say, we're
learning from our customers.
So for instance,
in depression, we
did a study where we had
400,000 customers participate.
And thanks to the participation
of so many individuals,
we were able to make
discoveries in depression.
And then you
potentially can analyze
all those genetic
variants and say,
this is one where we
think this is potentially
a drugable target.
So it's really hard to
do the micro attribution,
to say, hey, these individuals.
And plus, it's like a
10- to 15-year process.
So you might come back and
say, hey, 15 years later.
What we have found is what
people really care about.
We had a community
of individuals.
Actually, it was
someone from Google
actually who we worked
with, who had sarcoma.
She was like, I don't care.
What I care about is a cure.
I have sarcoma.
I have a lethal disease.
I would like to live.
And I find people
with serious illnesses
like that, they care
about two things.
Does this impact my children?
And I would like to survive.
But me coming to you and
saying, here's a check for $100.
I'm sorry you're going
to die soon, is not--
We want to do the right thing.
And everything at 23andMe, all
of our decisions that we make
are about what is in the best
interests of our customers.
And my customer is always the
individuals who've signed up.
And so we always
think about everything
from the perspective
of like, you just
participated in research.
What is it that is in the
best interest for you?
And if you tell
me, for instance,
that you have migraines,
and you have Crohn's, it's
our job then to help you
figure out the best ways
that you can
participate in research,
or for us to actually
move those things forward
to have some kind of
impact in your life.
And then you could
potentially help be a control.
There might be somebody
here who's like, oh,
I have a family history
of prostate cancer,
and we have depression.
And you can say, I can
be a control for you.
And in that way, everybody is
actually helping each other.
So it's hard to then
point to well, who exactly
is responsible,
because the reality is
it's really a community asset.
JORDAN THIBODEAU:
That makes sense.
For this survey aspect, when
you're a member of 23andMe,
they ask you questions.
Sometimes you probably might
get data that is just erroneous.
Do you use multiple data
points to figure out--
ANNE WOJCICKI: We do.
One of the things we found--
so this is a good example.
We put out questions
to our customers.
We have a pretty comprehensive
survey that we first
ask everyone to take.
And sometimes, you have
to refine the question.
So in this day
and age, everybody
thinks they have celiac disease.
But very few people have
actually gotten a biopsy.
So if I ask people, have
you had celiac disease,
the genetic associations
previously known
to occur with that
don't replicate.
But if I ask you,
do you have celiac,
and have you had a
biopsy to confirm it,
then I can actually
hit the replication.
I can find in the genetic
studies that known findings.
So we do find that we have
to triangulate questions
quite a bit.
Again, it's one of the things
that I learned from Google
and big data people is
that it's much better
to have like massive
amounts of dirty data.
And for us, we have now
5 million customers.
We have over 1.5 billion data
points on those customers.
We have the potential
to do a lot of research.
Without a doubt,
it's not perfect.
Not everybody reports
everything perfectly.
But it's pretty good.
And if I ask you, for
instance, do you have epilepsy,
you can probably report
that pretty accurately.
And so what we find is
that there's almost--
it's almost a false
truth that like, oh,
a clinical trial
is perfect data.
It was one thing
I learned when I
was on Wall Street is when
you have a multicenter
trial, if you have
20 different centers,
trying to diagnose a
partial response in cancer
is really controversial.
So a lot of aspects of medicine,
like defining a phenotype,
is controversial.
And in some ways, the best
thing that 23andMe does
is we have it all on a
very standardized form.
And we always have the ability
to go back to our customers
and ask, and say, OK, if you
said you had asthma, now,
we're going to go back
and ask you, and ask you
more about your medications,
when does it occur.
And you can start
to weed out when
something doesn't look real.
JORDAN THIBODEAU:
Now, I'm sure people
have seen the information
and they might
have overreacted or whatnot.
Have you considered connecting
23andMe to genetic counseling,
or providing people
information on how
to talk about these results with
their primary care physician?
ANNE WOJCICKI: Right.
We do actually connect people.
So the main thing that we try to
do that we feel really strongly
about is that health care--
a physician involvement or a
genetic counselor is up to you.
And so we never use that
as a bottleneck for access
to your information.
But if you find
out, for instance,
that you're positive for breast
cancer, the BRCA mutation,
you want to follow
up with a physician
or a genetic counselor.
And so we have had
partnerships in the past.
And we look at doing
that more and more, where
we might at least give
you advice, like, hey,
here are resources
where you can go to.
But we don't ever--
again, philosophically,
as a company,
we feel really strongly
that it's never
a bottleneck for access.
But we do provide
resources for people
so they know how to follow up.
JORDAN THIBODEAU:
For my friends who
I have convinced to try to
use 23andMe, some of them
have told me, well,
the reason why
I don't want to do it is
because if I know that I'd
be susceptible to a heart attack
or some other health problem,
I'd rather be left not
knowing the situation.
And then I have
heard from people
who've said, well, now that
I know I could possibly
have a health issue, it might
stress me out or something.
Have you done any research about
the psychological aspects of--
ANNE WOJCICKI: We have.
We have done a lot of research.
And actually, one
of the best studies
that was out there--
there was a guy
named Robert Green,
who was at Harvard.
And he did the original studies
on Alzheimer's and looking
at people.
It was a series of
studies called Reveal,
where he was able to see that
people-- like Alzheimer's is
one of the more extremes.
So people find out they're
genetically high risk
for Alzheimer's.
What do they do?
And he found that
initially there is anxiety.
But after three months,
you return to baseline.
And for a lot of
these individuals,
they already know
there's a family history.
So for instance, for
people who have, again,
the Alzheimer's variant, if
there's a high genetic risk
factor, you probably have
someone in your family network
who's had Alzheimer's.
So you know that you have some
kind of genetic risk factor
already.
So what we find--
and for me, the
story of genetics,
the reason why I was so
interested in genetics
is that you do have
genes and environment.
So your genetics are not--
unless it's Huntington's,
it's not deterministic.
It's not 100%.
You have this whole beautiful
world of your environment.
And so to me, the environment
is your responsibility.
That's what you can do.
You can do something
every single day
to influence your environment.
So without a doubt, there's
people who are genetically high
risk for Alzheimer's.
But they don't get it.
And so why?
That's one thing I'm really
passionate about personally
is looking at who
are the people who
are genetically high risk for
diseases who never get them,
and what was that in
their environment.
And the reality is, it goes
back to the original premise
of the company.
One of the issues is being
really healthy doesn't
make money in the system.
But 23andMe is really uniquely
set up in large in many ways
to do research on prevention.
So it's one of the
things we're really
passionate about is like,
look at the people who
have Alzheimer's and say,
OK, is it interval training?
Is it extreme exercise?
What is it that really has
an influence on your life?
And can we then help people take
responsibility on a daily basis
to try and actually
help prevent diseases?
Everyone gets sick at something.
It's one of the
things I always say.
People would say,
oh, you're just
going to have all
these healthy people.
And I was like, there's no
such thing as a healthy person.
Everyone has something.
It's like, it could
be depression.
It could migraines.
It could be stomach
problems, celiac, anything.
There's no such thing as
someone who's 100% healthy.
So for me, part
of it was helping
people realize that
your health is really
a sum of your actions
every day, and for us
to be able to do
that research on what
is it in our environment
that we can really do.
And the thing that I take most
pride in is rather than us
creating any kind of
anxiety or other issues,
is what people do.
It's like people are
looking to make change.
People got their
genetic information,
and it's something
in black and white.
And then they're looking
to make a change.
And I think the
number one disservice
that the health care
industry has right now is
there's not great support
for changing your behavior.
And people don't know how.
So often-- we heard
this with Alzheimer's.
I had one doctor.
He stood up at a
conference and complained.
He goes, one of the biggest
problems with 23andMe
is generate
non-billable questions.
And the reality is, you
show up and you say, oh,
I'm genetically high risk for
Alzheimer's, and they're like,
well, come back when
you have Alzheimer's.
That's what we do.
But when you think about
where do you go to prevent,
the number one
place where people
go to prevent any kind of
disease in this country
is realistically Walmart.
It's a behavior-- the
average American goes
to Walmart three times a week.
Or in this day and age,
it's going to be Amazon.
It's you're shopping.
It's your consumer.
It's how you are living
your life every day.
And one of the
things I really try
to hone in on our customers,
or hammer in on our customers,
is like, your health is a sum
of what you do every single day.
And so, again, going back to
the gene and environment pitch,
you can control
your environment.
You can't control
your genes, but you
can control your environment.
And we are trying to make
those discoveries about what
in your environment is
potentially going to influence
your genes the most.
JORDAN THIBODEAU:
So for those people
who are fearful about
putting their information
into the system, one
thing I keep on hearing
is, how do I know that my
genetic information will not
fall into the wrong hands?
Recently, we heard about
another genetic company.
I guess they were
hacked or whatnot.
So for someone who's fearful
about sharing information
to 23andMe, what
would you say to them?
ANNE WOJCICKI: It
was one of the things
early on for people
who are privacy--
we spent a lot of time
with privacy experts
in the early days.
And it was one of the
things I concluded then.
I was like, for people who
really care, I was like,
don't do it.
Just don't.
Spend the time.
Get comfortable with it.
What we can do as a company--
because there's a lot
of irrational fears,
and that's why we
used to say that.
As a company, we
have to do everything
we can to protect privacy.
There's fundamentally
no business model--
I'm totally dependent on
my customers' participation
and their trust
to do the research
and to do the types of
things we want to do.
So I have no business
model if I can't protect
the privacy of my customers.
So we do a lot, like from
a database infrastructure,
how we set it up, to even the
fact that it's not a swab.
It is two mills of saliva.
We reject samples if we
don't get enough saliva.
So you can't be accidentally
swabbed while you're sleeping.
It's a lot.
You'll never drool that
much in your sleep.
[LAUGHTER]
And so we've set up the company.
And also, we don't
have what we call
the legal chain of custody.
So if you order five kits,
I have no idea if you spat
or if you gave them away to
five random people in this room.
So I don't have the direct
tracing back to individuals.
From our terms of service as
well, we've specifically said,
it's not to be used
for law enforcement.
And we've set up the
company in such a way
to make sure that
it is really hard.
We have not gotten
a subpoena on this.
We've put out a
transparency report.
We would do everything we
can to fight a subpoena.
It hasn't happened for us.
But those are the
types of things where--
For people who are
really, really concerned,
just don't do it.
For people who are comfortable
with being on the web,
we do everything we can
to protect their privacy.
And one of the core elements,
like, one of the leading
privacy experts, one
of the things he taught
me was like, look, Anne, what
privacy people really want
is they want choice, and
they want transparency.
They want to know.
So if you're on 23andMe and you
don't want to share your data,
don't share it.
And we have to respect that.
So if you don't want to
participate in research,
you don't have to participate.
If you don't want to share
your genetic data with me,
don't share it.
If you want to share it with
five people in this room,
we allow you to share it.
So we've given you
a lot of controls.
And that's also one of the
things that's relatively
atypical in health care.
Like, if you wanted to share
your medical record with me,
it would be almost impossible.
So we do a lot to make sure
that we're empowering people
to have that privacy and
then have also the ability
to compare when they want.
One other thing is I just say
about there is when people
in general talk about privacy--
if I picked anyone
randomly in this room,
I'm sure your genetics
would be really interesting,
and I would love to see them.
But your bank account is
always much more interesting.
And so from a desire to
hack in to one or the other,
your bank is just a
lot more interesting.
And so when I look
at everyone's DNA,
and when I think
about privacy, it's
significantly less
on a mass area.
But what you see is within
a family, people will say,
I want to see if my
brother is really related.
Is he really my full brother?
And so you get some of those
intrafamily privacy questions,
rather than necessarily
a broad sweep.
JORDAN THIBODEAU: And
on the policy level,
are there things that 23--
are there policies
or legislation
that 23andMe is backing
on the federal level?
ANNE WOJCICKI: In
the early days,
there was something called
the Genetic Information
Non-Discrimination Act.
And it passed
unanimously, bipartisan.
It prevents insurance
health insurance companies
and employers from using genetic
information for discrimination.
So that was a huge step for us.
It leaves health
insurance outside.
I'm sorry.
It leaves life
insurance outside.
But that was a pretty
significant step
forward in terms of
giving federal protection
to help people feel
comfortable that they
can keep their genetic
information to themselves.
JORDAN THIBODEAU: Regarding
the life insurance aspect,
is there other
legislation that's
going to be proposed
in the future?
ANNE WOJCICKI: I haven't
seen anything now.
And it's interesting to me
because it's been 10 years,
and there hasn't really been
any movement or any interest
necessarily from
life insurance on it.
The reality we find, too,
is genetic information
is complicated.
It's not well understood yet.
So exactly how would you--
we already know some of
the biggest risk factors--
obesity, smoking.
Those are the biggest out there.
So other than like, OK,
you're genetically high risk
for a condition that we just
don't fully understand yet--
I'm much more optimistic
about, in my dream world,
that we would actually have
insurance companies embracing
it, and says, OK, you're
genetically high risk
for a blood clot,
and you're a woman.
You potentially are
higher risk then
for miscarriage and pregnancy.
We're going to try to
mitigate those risks
by x number of measures.
There's things I wish the
health care system would adopt
with genetic information
rather than being reactive,
but that hasn't
really happened yet.
JORDAN THIBODEAU:
So going forward
for the next 10 years
of 23andMe, where do you
see yourself with the company?
ANNE WOJCICKI: One of the
most interesting things
I see happening finally is that
there is an interesting world
of virtual health care.
So like Vic, who used
to run Google+ here,
who's now at a company
called the Alivecor--
my dad has AFib.
And he has a little
device on his phone
that measures your EKG.
And it will tell you whether
you're in atrial fibrillation.
That's amazing.
It's totally amazing.
You don't have to go in.
It's like you can get instant,
real-time information.
We're on the beach in Hawaii.
And He's like, oh, I'm in AFib.
Like, it's so--
[LAUGHTER]
It's utterly amazing.
And I think that
there's generally
a world that is
coming where you're
going to be able to get a lot of
your health care on your phone.
And is it taking a
picture of your mole
and then sending it in, and
you get multiple opinions?
Is it something like
grand rounds, where you
get multiple opinions online?
One of the things I'm
really hopeful for
is that health care becomes
less about the art of medicine
and much more data
driven, where you
get a number of people, a number
of opinions looking at a case.
And like again, on
the thing like a mole,
you can really apply
machine learning to that.
And so what are ways?
I see a whole new world
that is really cropping up.
And whether it's going to be
some kind of chatbot that's
telemedicine--
there's a lot that's
happening there.
So when I think
about 23andMe's role,
I think that we become
the hub in a large part.
Your genetic
information is the core.
It's like the
genetic code of you.
It is.
It's the digital
representation of you.
And so we're with
the epicenter of it.
And then helping you figure
out all the different ways
that you can navigate
that information,
and what can you do
with that information.
And we can't do that alone.
That's where we need partners.
I need ways that you
could potentially
analyze your blood
at home instantly,
or that you could take
a picture of your mole
and have it analyzed, a whole
way that you can actually
start to think about measuring
yourself at home, not unlike--
the quantified self
movement is more extreme,
but ways like the
average individual
wants to just be
healthy and proactive.
So I think that there's a whole
new world that is coming up,
which is almost
virtual health care.
And I think the
brick and mortar is--
we'll always have
hospitals, and we'll always
have brick and mortar,
but the same way there's
Blockbusters out there still.
[LAUGHTER]
There's not a lot.
And I think that, more and
more, you're going to see that.
Doctors visits are going to be
very different in the future.
My hope is the
research that 23andMe
can do is that we will make
a number of discoveries
about what is the meaning
of your genetic information,
and then also, what are
really meaningful ways
that you can prevent.
And when I think about
my ultimate success,
I would like to have cures.
I'd love to have a cure for
Parkinson's and other diseases.
And that is a high priority,
and we're booking on that.
But I'd also love to be
able to tell a 20-year-old,
this is what you need
to do to be able to live
to be healthy at 100.
And to me, that's real success.
JORDAN THIBODEAU:
So this kind of
goes into life
extension and longevity.
ANNE WOJCICKI: I
think life extension--
[LAUGHS] life
extension is like--
again, there's a lot of
Silicon Valley discussion
of like, oh, I want
to live to 500.
[LAUGHTER]
My goal is, I would just
like to be healthy at 100.
When I read stories
about 100-year-olds
running the marathons,
and doing things,
that's what you want to do.
I don't want to be in
our critical care unit,
supported at 100.
No.
I want to be healthy.
I don't want to be diabetic and
have congestive heart disease.
No.
Just let me be healthy,
and tell me how.
And again, it goes
back to this mantra
of health is what you
do every single day.
I dress like this because I'm
googly, but also because I
exercise all the time.
I biked here.
I'll bike back.
I'll bike home.
I love to humiliate
people in the office
when they take the elevator.
I'm like, why?
Like, why would you do that?
Why would you do it
in front of me too?
[LAUGHTER]
So I think it's really
important to get some
of those types of messages out.
JORDAN THIBODEAU: Excellent.
So now we're going to go
to audience questions.
So if anyone has a question,
please head over to the mic.
There's a mic right there.
You can just--
AUDIENCE: Over there?
JORDAN THIBODEAU: Yeah.
I'm going to check for
online questions too.
ANNE WOJCICKI: OK.
AUDIENCE: Hello.
Can you hear me?
Hi.
I'm from Argentina.
And there, when I
go to the doctor
with the 23andMe
report, the doctor,
typically, they tell
me something like, hey,
why you did this, as if
I did something wrong.
Like, why did you do this
without asking a doctor first?
So one of my
questions is related
is if you're doing something
to educate them in that sense.
And also, when they
see the possibilities
to get a disease they are
all taken into account,
compare it with people,
Caucasian people in Europe
because most of the research
has been done there.
But I am from Latin America,
so I don't feel represented.
I know that-- my
question is if you're
going to do some
something to have more
samples from that region so I
know that my test results are
more accuracy.
ANNE WOJCICKI: Yeah, sure.
AUDIENCE: And also, for someone
in Argentina, you have that.
I mean, you can't use 23andMe.
You have to come here.
ANNE WOJCICKI: Right.
AUDIENCE: So that's
the question.
ANNE WOJCICKI: Yeah, so the
first question on physicians
and second on international.
So physicians are
definitely the last mile.
It's painful for us.
And it's disappointing
to me because we
get a lot of people who take
their reports to physicians,
and the physician says,
oh, this is not worthwhile.
So you're not alone in that.
And we've tried some
initiatives, early initiatives,
to work with and
educate doctors.
And I always joke-- if I took
1,000 kits to Stanford Shopping
Center, and I was
like, these are free,
they would be gone
in five minutes.
If I took 1,000 kits to ASCO,
the big oncology meeting,
I would come home
with 990 of them.
We've literally tried to
give away kits to doctors,
and they're like, oh, no.
So there's a lot of
work that we have
to do to engage the
medical community.
One thing that I have
found is that there's
a new crop of physicians,
a lot of doctors who are
online and the telemedicine.
And it's something that
we're thinking about
is how do we cultivate
the physicians who
are trying to embrace
a world of prevention,
and what could you do with this.
And it's hard because it's
not a big reimbursement.
You can go to any dermatologist
and get Botox today,
in the next hour.
And if you said, I want to get
a mole check, they'll be like,
oh, in October, I
have time at 9:00.
[LAUGHTER]
And that's because a mole
check doesn't reimburse,
but Botox is $300 in 15 minutes.
So I think that's
where we have a lot
to do to try to work
with the physician world.
We're hiring someone.
That's a big initiative for
me on the team is how do we
engage the medical world.
Second on international,
the same way
we had regulatory issues
here, the rest of the world
is pretty complicated.
And there's a lot
of misunderstanding
about genetics.
So each country
has laws about how
to enter into those countries.
And they're pretty complicated.
We just haven't had--
I think a lot of startups
fail because they
try to do too much too early.
So we think about international.
And honestly, again, going
back to the love of hacks,
one of the ways I've thought
about just hacking it is just
like, just be in JFK in Miami,
and try to-- because then you
can actually pull a lot
of diversity in without
necessarily having--
and the reality is, the US is
this beautiful melting pot,
where, instead of
going into China,
which is really complicated,
I can go to San Francisco.
And so, for me, part
of it is making sure
that we're recruiting
the right populations.
And so we are
looking specifically
at targeting different groups.
And we have a big
African-American initiative.
We have a whole
global initiative
of countries where we're trying
to get specific populations,
both for the ancestry testing
so that we can improve
our product, but also then for
having the diversity in health
research.
AUDIENCE: Thank you.
JORDAN THIBODEAU: So I'm going
to take an online question.
ANNE WOJCICKI: Yeah.
JORDAN THIBODEAU: Who
owns the IP produced
from an individual's genotyping
data when they use 23andMe?
ANNE WOJCICKI: So there's
no IP in that capacity.
What happens, if you
spit, you own your data.
If you consent for
research, you're
consenting to be part
of this aggregate.
So for instance, if
I discover that--
I talk about 400,000 people
participated in the depression
study.
And so there's not IP on genes.
So we're not filing
patents, for instance,
on like oh, this
genetic association is
part of depression.
So there's no IP on that.
We might say, oh,
this mutation looks
like it's potentially
in an area where
it's potentially drugable.
We then make a small
molecule or an antibody.
And we're going to target that.
That is our IP.
Because in some ways, it's so
far downstream from everything.
Our hope is we are
publishing and putting out
into the public world all of the
genetic associations that we're
finding.
So we like to publish a lot.
We have over 100
publications out there.
But we really look at
the long-term downstream.
We're owning that
IP because we're
putting in, again, what's
going to end up being hundreds
of millions of dollars
of work into trying
to make successful discoveries
that will be cures.
AUDIENCE: Hi, Anne.
Thank you so much for coming.
I'm really inspired.
I'm [INAUDIBLE].
I'm the Google Doodles PM.
I wanted to ask about how
you attract and retain
so many women.
From everyone I talk
to, in your company,
they're so happy there.
How do you do it,
especially now, really,
especially now that so many
women are feeling like they
can't stay in tech long term?
ANNE WOJCICKI: You
know, we had a problem
for a while where we were
trying really hard to hire
a man for the management team.
[LAUGHTER]
And I remember.
They were looking for a head
of engineering at one point.
I remember we had this woman.
And we were like, no,
no, no, we need a man.
Like, we need at least one!
So I mean, I think it's like
all aspects of diverse--
I think we've tried really
hard to have a supportive
environment.
And for me, I always say, I've
worked for really bad people.
I've worked for like some
really complicated funds.
I was like, who in the room
is anyone who's been in jail?
I have bosses
who've been in jail.
So I've worked for some really
challenging individuals.
So I know what it's like.
And I'm trying to do
the exact opposite.
The first job I ever had, the
Wallenberg family in Sweden,
they were amazing.
They treated me so well.
So I know what it's
like to have a bad job
and a bad environment.
I know what it's like to
have a great environment.
And in Sweden, for instance,
this woman showed up one day.
And I was like, who are you?
And she was like, oh, I'm
newly promoted partner.
I've been on maternity
leave for two years.
And I was like, what?
[LAUGHTER]
So it was one of those
things, like, culturally it's
set to me, like, here's a group
of people, the Wallenbergs, who
promoted this woman who's
been on maternity leave
for two years?
It was amazing.
And so I really try to create a
culture where we support people
through their life cycle.
And a lot of people have
been at the company, who
they get married, they've
had kids, they get divorced.
There's a whole life cycle.
And not everyone is
awesome every day.
And so you could be
awesome for a while,
and then you have a kid, and
the kid's sick for a while,
and you have to take off time.
I can't be the asshole boss
that's like, oh, my god.
You're out.
I have to support people.
And I look at people
for the sum of like--
I hope people stay for 10 years.
And I look at
people for the sum,
like what can you
contribute in that period?
And how do we also support you?
We're really very much like,
your family is your family,
but we're your family
away from home.
And so I have to support
people in a good way.
And I have to listen.
And I think it's like
there's a level of humility.
The number one thing we
have for hiring is humility.
You need really smart people.
But culturally, you got to
fit in with the humility.
And we have to support people.
AUDIENCE: Thank you.
ANNE WOJCICKI: You're welcome.
AUDIENCE: Hey.
Thanks for doing this.
ANNE WOJCICKI: Of course.
AUDIENCE: So I know there might
be some liabilities associated
with the idea I'm
about to mention.
But is there some time when this
would be an opportunity finding
tool as well, that
your DNA seems
like you would be perfect
for pole vaulting,
so practice away?
[LAUGHTER]
JORDAN THIBODEAU: [INAUDIBLE]
ANNE WOJCICKI: I don't
know if we'll ever get down
to those types of specifics.
I think that for
sprinting, there's
genetic variance associated with
do you have the double twitch.
Will it ever refine
enough to be able to say,
oh, you're really great
at this specific sport?
I think, again, it goes
back to the world of genes
and environment.
You need passion.
To be great at anything,
you need passion.
The most important aspect for
me out of that movie "Gattaca"
was that this guy
has a genetic--
he's genetically not likely
to survive for some reason.
But he has the passion.
And passion accounts
for so much.
So I think without a doubt
you'll hear things like,
if you are--
we did some research at one
point on being tone deaf
or having a musical ear.
And you could imagine at some
point, would you say, OK, like,
hey, you're just not--
if you want to be
a pianist, you're
going to have to work
that much harder.
And we did a study, for
instance, in weight loss.
My hope one day is be able
to say, if you're overweight,
it's only going to take you
four weeks to lose weight.
You, it's going to
take you seven weeks.
You're just genetically
more likely to not
be able to lose that weight.
And I think that's where it
will help people, not know, oh,
you're not going to
be great at this,
but like, you just might
have to work harder.
Instead of the famous 10,000
hours, you need 12,000 hours.
AUDIENCE: Yeah.
Cool.
Thank you.
ANNE WOJCICKI: OK.
AUDIENCE: Hi.
Thanks for coming.
This is very interesting.
So I was wondering.
I noticed that-- I mean,
so there's 23andMe.
But there's also lots of
other similar companies.
So if you're
looking at ancestry,
you get to link and find
out your relatives who
are with 23andMe.
But then there's people who
are with other companies.
It seems like everything's
kind of siloed.
Have you thought about
talking to other companies
and seeing if there are
ways that you can connect
across each other's databases
to help people find relatives
who are with other companies.
ANNE WOJCICKI: Yeah.
We did a promotion,
for instance,
on DNA Day, where we allowed
people from ancestry.com
to upload their data.
The companies are pretty
competitive right now,
so there hasn't been any
specific initiative to try.
You can always download
and I think upload.
So no.
I mean, it's a problem.
It's not in the best interests
of customers for sure
to not allow--
I would think that
that would actually
be something that's great.
But I think there's a lot
of competition right now.
So that hasn't happened.
But without a doubt,
we know that people
who are looking for
family members oftentimes
will do both services.
AUDIENCE: OK, thanks.
ANNE WOJCICKI: And again, we
might do more in the future.
And in some ways, this goes
with some of the privacy issues.
So again, you were talking
about the Golden State Killer.
One of the things
that's important for us
to do from a privacy perspective
is not allow relative matches
from DNA that's uploaded.
Because if you
allow that, then you
open up the door for things
like the Golden State Killer.
And so for instance, when
we did this promotion--
anyone could upload their
DNA from other places--
we would tell you
if there was someone
within your close circle, but
we wouldn't identify who it is.
And we did that.
And you would have
to spit again.
And we did that specifically
from a privacy perspective.
We think a lot about privacy.
AUDIENCE: Cool.
Thanks.
ANNE WOJCICKI: You're welcome.
AUDIENCE: Hi.
And so say I submit my spit,
and then I get it back,
and then it tells me
about my ancestry,
and all my health prospects.
Is there a way I
could prevent myself
from having cancer in
future, just off of that?
ANNE WOJCICKI: We don't
have-- so the cancer
report we have right now is
the breast cancer report.
That is associated with
typically Ashkenazi
Jewish descent.
And it does have a high
penetration of cancer,
meaning those people are
likely to get cancer.
What we found
people have done is
they go and they get
either mastectomy,
or they take out their ovaries.
So there's ways that
you can potentially--
it's extreme to prevent.
The other thing
that's out there is,
for instance, there's people
who are genetically high risk
for colon cancer.
And in that capacity,
right now, I
think the recommendations
are colonoscopies at 45.
In that case, you could start
having colonoscopies earlier.
So a lot of it,
there's not necessarily
known specifics about OK, if
you want to prevent cancer,
these are the
things that you do.
In every disease
area, you can say,
don't smoke, exercise,
and eat better.
And what we find
that having something
that is a risk factor in
black and white in your DNA
motivates people to actually
do all those things.
But those are the
biggest swing factors
you have always is your
exercise, and your diet,
and your environment.
AUDIENCE: OK.
Thank you.
ANNE WOJCICKI: You're welcome.
AUDIENCE: Hi.
My name is Julia.
And I'm an intern in
Google Brain in genomics.
And it looks like Google is
also looking into genetics
and predicting
disease from genetics,
and also connecting
it to health care.
I know that also
Microsoft is looking
into health care and genetics.
So what do you think about this?
Do you think that you
will cooperate with Google
or Microsoft at some point,
or you will be competitors,
or 23andMe is so far ahead
in this research that--
ANNE WOJCICKI: So I've spent a
lot of time in the early days,
back when we were starting
the company, like, Google,
Microsoft, others--
like Microsoft
had RFPs out for a while
doing genetic research.
They've had a great--
they had a really great team.
Google Brain team is amazing.
I know Jeff Dean well.
It's an amazing group of
people that are there.
The number one problem
in health care, I find,
is nobody has the dataset.
I love going to
big data meetings,
and everyone's talking
about big data.
And I'm like, but you
don't have any data.
I mean, it's fascinating.
it's.
Like the emperor has
no clothes, people.
There's not a lot
of data out there.
So I mean, there's some
of these big initiatives.
And my whole goal was
like, I want the data.
Like 23andMe's
initial premise, I
was like, you need to
generate the data first.
And so the number one
thing that we have is we
have a massive living
dataset, where I can go back
to my customers and say,
OK, do you have migraines,
can you tell me
more information.
And for those customers
who want to participate,
they can tell me more.
And so it's one of the things.
There's the UK
biobank, and there's
all these other
biobanks out there.
But they're static.
We did this project with
this one group in the UK.
And I requested a sample.
It was a recontactable database.
I requested samples.
Three years later, they
called me, and they're like,
we have the samples.
I was like, who are you?
Like, what is-- I
was like, oh, yeah,
that's their definition
of recontactable.
In this world of
the internet age,
just text me or
send me a message.
Have it show up as
an alert on my phone.
So that's the main thing.
The key that we'd
created, I needed
to first create the data before
I can solve the problems.
There's amazing people out there
who can solve the problems.
But it's really hard.
There's no one
else out there who
has the amount of data we have.
And like I said, I
know Jeff Dean well.
I know that team well.
If you know Lizzie, like--
we love that team.
We're always open to working.
Or just join us.
[LAUGHTER]
AUDIENCE: And another question--
JORDAN THIBODEAU:
Oh, we're going
to make this the last question.
AUDIENCE: Oh, so can I?
JORDAN THIBODEAU:
Yeah, just go ahead.
AUDIENCE: OK.
So I saw that 23andMe is hiring
machine learning specialists.
So do we understand that
23andMe use machine learning?
Or is it mostly
looking into literature
and see which variant is
connected to which disease
from literature?
ANNE WOJCICKI: So we do a lot.
We have a pipeline,
where we're doing
our own genome-wide association
studies quite a bit.
We are starting to do a fair
amount of machine learning
and thinking about--
So for instance, one of
the first applications
probably is an ancestry
and helping people
in predicting ancestry.
We have a number of
initiatives in house.
And those are the types
of things we thought of.
But again, with all
the data that we have,
we're right for all
those technologies now,
all the applications.
So again, my job is, being
somebody who's not technical,
is like, I'm trying to create
first this massive enthusiasm
from the world to
participate in research
and to learn about
their genetics,
and then create data that has
the data quality that we need
to do that research, and then
to empower everybody with all
the different
techniques and skills
to then analyze the data,
and what can we do with it.
AUDIENCE: Thank you.
ANNE WOJCICKI: You're welcome.
JORDAN THIBODEAU: Thank you.
Well, Anne, thank you
very much for joining us.
Let's give her a
round of applause.
ANNE WOJCICKI: Thank you.
It was so fun.
[APPLAUSE]
