EXAS

Key Highlights

• Revenue grew 20% to $851 million, with highest quarterly growth in over 2 years, driven by Cologuard's strong brand, commercial execution, health systems integrations, and new test launches like Cancerguard.
• Cologuard saw broad growth: 0.25 million more people screened in Q3 vs last year, over 12,000 new ordering providers, and Cologuard Plus launched with top 10 payers covering it.
• Precision Oncology revenue up 12% on core basis, fueled by Oncotype DX expansion internationally and U.S. volumes.
• ExactNexus platform integrated in primary care workflows, Cancerguard launched for multi-cancer early detection, and pipeline includes liver, esophageal, and endometrial cancer tests.

Guidance

• Raised full-year 2025 revenue to between $3.22 billion and $3.235 billion. Screening revenue expected $2.51-$2.52 billion (20% growth at midpoint). Precision Oncology revenue $710-$715 million (9% growth at midpoint).
• Adjusted EBITDA guidance raised to $470-$480 million, with margins at 14.7% at midpoint.

Total revenue grew 20% year-over-year to $851 million. Screening revenue increased 22% to $666 million, contributing approximately 78.26% of total revenue. Precision Oncology revenue rose 12% to $183 million, contributing ~21.50% of total revenue. Adjusted EBITDA was $135 million, up 37% year-over-year, with margins expanding to 16%. Free cash flow was $190 million in the quarter, and year-to-date free cash flow was $236 million, up 270% year-over-year.

Risks

• Non-GAAP gross margins down 100 basis points in Q3 due to record care gap shipments causing timing differences between cost of goods and revenue.
• Uncertainties around payer coverage and contracting for new tests like Cancerguard Plus, and potential challenges in sunsetting Cologuard in favor of Cologuard Plus.
• Competition in the multi-cancer early detection space, including from competitors like GRAIL, which could impact market share and adoption of new tests.

Q: Vijay Kumar inquired about screening performance drivers and 2026 guidance A: Kevin Conroy and Aaron Bloomer discussed strong screening growth from care gaps, rescreens, and first-time users, noting 2026 guidance will be reviewed at the next earnings call Q: Tycho Peterson asked about care gap impact on margins and Cancerguard reimbursement A: Aaron Bloomer discussed care gap investments boosting growth but temporarily lowering margins, while Kevin Conroy talked about Cancerguard pricing and sustainable payer coverage approaches Q: Patrick Donnelly asked about Freenome timelines and internal programs A: Kevin Conroy mentioned Freenome V2 data expected soon and internal programs continuing, with excitement about bringing the test to market Q: Bradley Bowers inquired about Cologuard Plus sunset plan and payer contracting A: Kevin Conroy discussed ongoing discussions with payers for Cologuard Plus coverage, with plans to sunset Cologuard next year Q: Other questions covered topics like OpEx, rescreen penetration, telehealth integration, and Oncodetect MRD test impact, answered by Aaron Bloomer and Kevin Conroy