I read it the opposite way - your chances of having a big impact are low, so stop worrying and start a company anyway. This might sound paradoxical, but for a lot of people (myself included) being told "don't waste your time on something trivial" can be
paralysing. You end up questioning every idea and never being able to settle on one.
You can (and should) get a sense of which ideas are worthwhile, but you'll never know for sure. Maybe your potential cure for cancer won't work. Maybe your todo list app will help 100 medical non-profits each be 5% more efficient, in effect having 5 non-profit's worth of impact. With that in mind, the best you can do is pick something that you can probably make work, that people probably want, and that will probably have a positive impact on society. Whether or not you change the world is up to the gods.