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what it is
Exact Sciences makes cancer screening and treatment tests that help find disease early and guide therapy.
how it gets paid
Last year Exact Sciences made $3.2B in revenue. Cologuard screening was the main engine at $2.3B, or 72% of sales.
why it's growing
Revenue grew 17.7% last year. Exact sciences maintained strong top-line momentum during the fourth quarter.
what just happened
Revenue hit $2.4B, but EPS was still -$0.65.
At a glance
B balance sheet — gets the job done, barely
40/100 earnings predictability — expect surprises
688.3x trailing p/e — you're paying up for this one
4.5% return on capital — nothing to write home about
$0.15 fy2027 eps est
xvary composite: 40/100 — below average
What they do
Exact Sciences makes cancer screening and treatment tests that help find disease early and guide therapy.
Cologuard brought in $695M last quarter. Screening revenue -> money from tests -> cash that keeps the lab busy. You do not switch insurers, doctors, and follow-up like a phone plan. 7,000 employees at year-end make that machine hard to copy.
How they make money
$3.2B
annual revenue · their business grew +17.7% last year
Cologuard screening
$2.3B
+26.0%
Oncotype IQ
$0.6B
+8.0%
Lab services
$0.2B
+5.0%
Other revenue
$0.1B
0.0%
The products that matter
at-home colon cancer screening
Cologuard
part of a $2.8B flagship revenue base
this page does not break out standalone sales, but Cologuard and Oncotype DX together generated $2.8B in 2025 revenue. Cologuard is the better-known consumer-facing piece of that story.
core driver
breast cancer treatment guidance
Oncotype DX
part of a $2.8B flagship revenue base
Oncotype DX helps determine whether patients need chemotherapy, and it sits inside the same $2.8B pair with Cologuard. That makes it central to the current revenue base, not a side project.
clinical utility
next-gen screening launch
Cologuard Plus
tied to the 30%+ growth case
the page's own upside case points to 30%+ growth potential if Cologuard Plus adoption lands as management projects. That's not current profit. That's future execution.
next chapter
Key numbers
$0.15
fy2027 eps est
$5B
fy2029 rev est
688.3x
trailing p/e
69.5%
gross margin
Gross profit kept about 69.5% of each revenue dollar.
Financial health
B
strength
- balance sheet grade B — adequate — nothing special
- risk rank 4 — safer than 20% of stocks
- price stability 15 / 100
- long-term debt $2.3B (15% of capital)
- net profit margin 4.2% — keeps 4 cents of every dollar in revenue
- return on equity 8% — $0.08 profit for every $1 investors have put in
B — functional but not a standout on the balance sheet.
Total return vs. market
You invested $10,000 in EXAS 3 years ago → it's now worth $15,780.
The index would have given you $13,880.
source: institutional data · total return
What just happened
missed estimates
Revenue hit $2.4B, but EPS was still -$0.65.
Revenue jumped 178% vs. prior year, and gross margin was 69.5%. The loss stayed negative, so scale still has not fixed profitability.
$800M
revenue
-$0.65
eps
69.5%
gross margin
the number that mattered
The $2.4B revenue number matters because the business got much bigger, but the -$0.65 EPS loss says profits still leak out.
-
exact sciences has agreed to be acquired by abbott labs.under the terms of the agreement announced on november 19th, abbott (nyse: abt) would acquire all outstanding shares of exact sciences for $105 in cash per common share, at a total equity value of $21 billion and estimated enterprise value of $23 billion. the merger stands to provide abbott an immediate leadership presence in the rapidly growing cancer diagnostics segment, which exact sciences successfully penetrated to the tune of $3.25 billion of revenue during 2025. abbott will accelerate exact’s comprehensive product offerings that include cologuard, a marketleading non-invasive colorectal cancer screening test; oncotype dx, which aids in making personalized treatment decisions for breast cancer patients; oncodetect, which identifies molecular residual disease and assesses the risk of recurrence; and cancerguard, a multi-cancer early detection test. exact sciences also continues to invest in a robust pipeline of advanced cancer diagnostics aimed at improving outcomes, including its oncoguard liver cancer blood test that is evidencing tremendous early effectiveness. we expect the transaction to close during the second quarter, pending regulatory and exact sciences’ shareholder approvals, as well as other customary closing conditions.
-
exact sciences maintained strong top-line momentum during the fourth quarter.
-
december-interim results included record revenue of $878 million, an increase of 23% over the prior-year period tally of $713 million, slightly ahead of our forecast.
-
screening revenue increased 26% to $695 million, as the number of cologuard ordering providers and brand awareness continued to strengthen.
-
free cash flow of $120 million represented a whopping $110 million improvement over the prior-year period, while the full-year total of $356 million increased $283 million, or 387% vs. prior year.
source: company earnings report, 2026
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What could go wrong
the #1 risk is Cologuard Plus adoption and reimbursement not matching the growth case.
med
the upside case leans on a product ramp that has not fully shown up yet
This page explicitly ties 30%+ growth potential to Cologuard Plus adoption. That makes adoption the thesis, not a side note.
If that ramp slips, the gap between a $13B market value and today's 4.2% net margin gets harder to defend.
med
two products carry most of the revenue base
Cologuard and Oncotype DX generated $2.8B in 2025 revenue versus $3.2B for the company overall.
When most of the business sits in two flagship tests, reimbursement pressure or slower volume growth hits the story quickly.
med
great gross margins are not yet turning into great shareholder returns
Gross margin was 69.5%, but net margin was only 4.2% and return on capital was 4.5%.
That spread tells you the issue is not test economics. It is cost structure, scale, and whether the company can keep more of each dollar.
med
the stock is priced on future earnings that barely exist today
Trailing p/e is 688.3x, while fy2027 eps is estimated at just $0.15.
You do not need a collapse for the stock to re-rate. You just need growth to stay good instead of great while earnings stay small.
$2.8B of a $3.2B revenue base sits in two core tests, and the stock trades at 688.3x trailing earnings. That is a narrow margin for error.
source: institutional data · regulatory filings · risk analysis
Pay attention to
calendar
next earnings report
this page does not list the date. that's a real gap, because a 40 / 100 predictability score means earnings are the event.
metric
revenue path to $5B
the street is modeling $5B in fy2029 revenue from $3.2B today. that scale-up is the backbone of the current valuation.
trend
whether gross margin finally becomes net margin
69.5% gross margin looks excellent. 4.2% net margin does not. closing that gap is the whole operating-leverage story.
risk
Cologuard Plus adoption
the page's own bull case references 30%+ growth potential if adoption lands. if it doesn't, the stock stops looking patient and starts looking expensive.
Analyst rankings
earnings predictability
40 / 100
in human-speak, analysts do not trust this earnings stream to behave cleanly yet. expect revisions and uneven quarters.
balance sheet grade
B
the balance sheet is serviceable. You are not buying a distressed company, but you are not getting balance-sheet luxury either.
source: institutional data
Institutional activity
institutions have been net buying for 2 consecutive quarters — 272 buyers vs. 234 sellers in 3q2025. total institutional holdings: 0.2B shares. net buying for 2 quarters.
source: institutional data
Price targets
3-5 year target range
$35
$146
$103
current price
$91
target midpoint · 12% from current · 3-5yr high: $130 (+25% · 6% ann'l return)
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