Most cancers are caught too late, and Ryuichi Onose has spent the last seven years trying to change that.

His company, Craif, can detect 10 of the most common cancers from a urine sample, before symptoms, before scans can even see anything. Their accuracy for stage one pancreatic cancer sits at 93%, compared to 37% for the standard blood marker test.

Ryuichi was 26 and managing ships at Mitsubishi when his grandmother died of stage four colorectal cancer in three weeks. He had no biotech background. He left anyway. Now Craif has sold over 50,000 tests across 2,000 hospitals and 4,600 pharmacies in Japan, raised $60 million, and is expanding into the United States.

In this conversation, Ryuichi talks about the science, the business, and what it means to build a company around a problem that keeps getting more personal. His grandfather got sick too. And then, two weeks before we recorded this, his father was diagnosed with prostate cancer.

He also shares where he wants to take this next: a toilet that monitors your urine passively, flags changes, and notifies your phone. The goal is to make prevention so frictionless that people don't have to rely on willpower or remembering to book an appointment.

(00:00) Introduction

(03:48) What Is Craif?

(06:30) The Science Behind the Test

(11:49) Craif Goes to Market

(15:37) The Smart Toilet Vision

(17:47) Growth, Scale and AI

(19:44) Ryuichi's Origin Story

(24:40) When Cancer Gets Personal

(28:53) Fate and Coincidence

(30:43) Presence, Balance and Fatherhood

(36:30) Beyond Cancer: The Bigger Vision

(41:53) Bringing Craif to America

(45:35) Growing Up as a Misfit

(48:34) Leadership and Culture at Craif

(51:22) The Hardest Part of the Mission

(55:06) How to Get Involved

(56:51) Closing Words