Exact Sciences (EXAS -11.05%), a leading provider of cancer screening and diagnostic tests, reported its Q2 2025 earnings on August 6, 2025. Revenue and GAAP earnings both exceeded analyst expectations, as new products and improved commercial execution powered performance above consensus expectations. GAAP revenue came in at $811 million for Q2 2025, above the analyst estimate of $773.8 million (GAAP), representing a 16.0% increase from the prior year’s quarter. Non-GAAP EPS reached $0.22 for Q2 2025, far exceeding the GAAP estimate of a ($0.13) loss and Non-GAAP EPS was $0.22, a 57.1% increase from Q2 2024. Adjusted EBITDA reached $138 million for Q2 2025, a 25.5% increase from Q2 2024, while raising its full-year 2025 guidance for revenue and adjusted EBITDA. This strong quarter reflected robust adoption of new cancer tests, ongoing cost controls, and advancing progress in Exact Sciences’ strategic initiatives.
| Metric | Q2 2025 | Q2 2025 Estimate | Q2 2024 | Y/Y Change |
|---|---|---|---|---|
| EPS (Non-GAAP) | $0.22 | N/A | $0.14 | 57.1 % |
| Revenue | $811 million | $773.8 million | $699 million | 16.0 % |
| Adjusted EBITDA | $138 million | $110 million | 25.5 % | |
| Free Cash Flow (Non-GAAP) | $46.7 million | $71.2 million | (34.4 %) | |
| Adjusted Gross Margin | 72 % | 73 % | (1.0) pp |
Source: Analyst estimates provided by FactSet. Management expectations based on management's guidance, as provided in Q1 2025 earnings report.
Business Overview and Recent Focus
Exact Sciences specializes in cancer diagnostics, focusing on developing and commercializing non-invasive screening and diagnostic tests. Its offerings include the Cologuard test for colorectal cancer and a range of precision oncology tests like Oncotype DX, which guides cancer treatment decisions. The company’s business model is centered around early cancer detection, wide market access, and driving recurring usage through physician and patient engagement.
Recently, Exact Sciences has focused on three main areas: expanding its cancer test pipeline, strengthening its commercial reach, and achieving operational improvements. Success factors include rapid product innovation, securing broad insurance coverage for new tests, and building strong partnerships with healthcare providers. Recent launches such as Cologuard Plus (an advanced version of its original stool DNA test) and Oncodetect (a molecular residual disease test) are key to its growth plans, while cost management and productivity initiatives help improve margins as the company scales up.
Quarter Highlights: Financial Results and Execution
Exact Sciences exceeded analyst expectations for GAAP revenue and GAAP EPS. The company delivered GAAP revenue growth of 16.0% for Q2 2025, which outpaced the analyst estimate by $37 million (GAAP), driven by higher sales and improved operational efficiency. Adjusted EBITDA was $138 million, an increase of 26% from the prior year, with adjusted EBITDA margin improving 130 basis points to 17%.
The screening segment, including Cologuard Plus and PreventionGenetics, generated $628 million in GAAP revenue for Q2 2025, up 18%. The precision oncology segment, which includes products like Oncotype DX and Oncodetect, contributed $183 million in GAAP revenue for Q2 2025, Precision oncology segment revenue was $183 million, an increase of 9% from Q2 2024. Recurring usage remained a focus, with rescreens representing over 25% of Cologuard volume in Q1 2025.
Gross margin was 69% (72% adjusted), and operational leverage was visible. Deployments of Cologuard Plus began reaching scale: this next-generation stool DNA test detects colorectal cancer with increased sensitivity (ability to detect cancer) and specificity (ability to avoid false positives). Its launch targeted Medicare Part B patients, who made up 14–15% of the relevant group as of Q1 2025, with broader coverage expansion being pursued. Oncodetect, a molecular test for residual disease detection, gained Medicare coverage for serial use in patients with stage II, III, and resectable stage IV colorectal cancer in the adjuvant and recurrence monitoring settings over a five-year period as of Q2 2025.
Sales and marketing spending (GAAP) increased 16.8% compared to Q2 2024, but overall revenue growth outpaced these investments. General and administrative costs also rose, partly offset by productivity measures. Free cash flow declined to $46.7 million from $71.2 million, but the company ended the quarter with $858 million in cash and marketable securities, up from $600 million at year-end 2024.
The company continues to reinvest cash flow into growth and product launches.
Product Portfolio, Commercial Progress, and Market Trends
Exact Sciences’ leading products span two main groups. In cancer screening, its headline product is Cologuard, a stool-based DNA test for home colorectal cancer screening. The advanced Cologuard Plus, launched this year, offers higher sensitivity and specificity and Cologuard Plus is being ramped up through physician outreach. Among precision oncology offerings, Oncotype DX is a genomic test that helps guide treatment decisions in various cancers, while the new Oncodetect test helps monitor for the return of residual disease after cancer treatment.
“Doc calls”—direct provider engagement contacts—rose 30% year over year in Q1 2025, and Per-rep productivity increased 10% in Q1 2025. Direct-to-consumer orders for Cologuard grew by triple digits in Q1 2025. In screening, more than 25% of revenue came from existing patients rescreening in Q1 2025.
Precise segmentation of payers remains crucial. Pricing and reimbursement for Cologuard Plus currently target only Medicare Part B (about 14–15% of the potential market) as of Q1 2025, but management is working actively to secure coverage with commercial insurers and Medicare Advantage plans. Progress with payers is described as positive, but uptake for new tests beyond Medicare is expected to be gradual in the near term. The company is also preparing for the commercial launch of Cancerguard, its multi-cancer early detection blood test, in the second half of 2025.
Gross margins in new tests are comparable to legacy products, with expected improvement from manufacturing cost initiatives. A multi-year productivity plan is underway, targeting $150 million in annual savings by FY2026. However, Management noted that sales and marketing as a percent of revenue, at around 30% in Q2 2025 (GAAP), remained elevated due to launch investments.
Competitive positioning remains a topic of investor focus. While Exact Sciences is the leader in non-invasive stool DNA screening, new competitors are developing blood-based cancer screening tests. Management notes its first-mover position, brand strength, payer relationships, and investment in product innovation as key advantages, but acknowledges ongoing risks as the cancer screening landscape evolves. Key factors to monitor include the timeline for commercial insurance adoption of new tests and the regulatory pathway for innovations like Cancerguard.
Outlook and What to Watch
Following the strong quarter, management raised its full-year 2025 outlook. Revenue guidance for FY2025 is now $3.130–$3.170 billion, with the midpoint up $55 million from prior projections for full-year 2025 total revenue guidance. Adjusted EBITDA is expected to reach $455–$475 million for FY2025, 44% higher than the prior year and reflecting improved profitability. Segment guidance was also increased: screening revenue is now expected between $2.440–$2.470 billion (up 17%), and precision oncology to $690–$700 million (up 6%) for FY2025. Capital expenditures and free cash flow remain positive.
Management identified successful expansion of coverage for Cologuard Plus and Cancerguard as essential for additional upside. Key upcoming milestones include payer negotiations for broader reimbursement, a midsummer 2025 release of top-line data from the BLUE-C pivotal trial for blood-based CRC screening, and continued ramp-up of Oncodetect.
Revenue and net income presented using U.S. generally accepted accounting principles (GAAP) unless otherwise noted.
