Exact Sciences Corporation

Total revenue was $851 million, up 20% year over year and $43 million above the midpoint of guidance. Screening revenue increased 22% year over year to $666 million, and precision oncology revenue increased 12% on a core basis to $183 million. Adjusted EBITDA was $135 million, up $37 million or 37% year over year, with adjusted EBITDA margin at 16%, up 200 basis points. Non-GAAP gross margin was 71%, down 100 basis points year over year, due to timing from record care gap shipments. Free cash flow was $190 million, up $77 million, and year-to-date free cash flow was $236 million, up 270% year over year. Full-year 2025 guidance was raised to revenue of $3.22 billion-$3.235 billion and adjusted EBITDA of $470 million-$480 million; screening revenue guidance was $2.51 billion-$2.52 billion and precision oncology revenue guidance was $710 million-$715 million. Management said Q4 gross margin should improve as care gap shipments ease, and Q4 marketing spend will step up for Cancerguard.

Kevin Conroy said the quarter reflected an inflection point, driven by stronger commercial execution, deeper health-system integration, and the expanding power of the Cologuard brand. He highlighted Cologuard Plus performance, saying it delivers 95% sensitivity and 94% specificity and has positive coverage decisions from the top 10 payers. He was upbeat on Cancerguard’s launch, ExactNexus, and the company’s ability to use its provider relationships and consumer tools to expand screening over time.

Aaron Bloomer focused on the financial leverage in the business and specific margin/cash drivers. He noted revenue of $851 million, adjusted EBITDA of $135 million, non-GAAP gross margin of 71%, and free cash flow of $190 million, with cash and securities just over $1 billion. He said the Q3 gross margin headwind came from record care gap shipments, expects Q4 gross margin to step up, and said the $150 million productivity program is tracking well with 2025 one-time expenses now expected at about $85 million. He also said the full-year adjusted EBITDA guide excludes any potential Freenome licensing impact, because the $75 million upfront payment will be expensed to R&D when HSR clears.

Analysts focused on what drove the screening outperformance, how durable care gap demand is, and how management is thinking about 2026, Cologuard Plus contracting, and the Cancerguard and CRC blood launches. Management said broad-based growth came from care gaps, rescreens, first-time providers, and CIO, and that screening is pacing ahead of the long-term 15% CAGR target through 2027. On Cologuard Plus, management said the top 10 payers have positive coverage decisions, 4 of the top 10 are contracted, 6 remain in discussion, and that Cologuard will eventually be sunset in favor of Cologuard Plus. On Freenome, Kevin Conroy said concept data should come in the next few months, pivotal data next year, and that Exact Sciences retains exclusive CRC marketing rights.