Every industry has companies that qualify as "haves" and others that are "have nots." In genetic testing, Exact Sciences (NASDAQ:EXAS) definitely belongs in the former category this year, with its shares soaring 55%. Myriad Genetics (NASDAQ:MYGN), on the other hand, is more of a "have not" in 2019. The stock is down close to 6% year to date.

But which of these stocks is more likely to be the bigger winner over the long run? Here's what you need to know to choose between Exact Sciences and Myriad Genetics.

Test tubes with one containing a DNA helix image

Image source: Getty Images.

The case for Exact Sciences

There's no secret as to why Exact Sciences stock has skyrocketed this year. The company has delivered tremendous revenue growth. In its latest quarter, Exact Sciences' sales soared 85% year over year to $219 million.

Cologuard remains the key to the company's success. Exact Sciences CEO Kevin Conroy said in the company's Q3 conference call that 456,000 people were screened for colorectal cancer with the Cologuard DNA test. Over the last five years, over 3 million people have been screened using Cologuard.

Going forward, Exact Sciences will have more than just one product driving its growth. The company closed on its merger with Genomic Health in November. The deal enabled Exact Sciences to gain Genomic Health's Oncotype DX genomic test for detecting breast cancer.

Exact Sciences could have additional growth drivers on the way. In November, the company picked up FDA Breakthrough Device Designation for its experimental liquid biopsy for detecting liver cancer. It hopes to launch the product in the second half of 2020. Exact Sciences is also testing a new version of Cologuard that could expand the market for its successful colorectal cancer DNA test.

Despite its fast-growing revenue, Exact Sciences still isn't profitable. The company also faces several risks, perhaps the most significant of which is that a more accurate or more convenient colorectal cancer test could be introduced to the market. 

The case for Myriad Genetics

While everything is going well for Exact Sciences right now, the opposite is true for Myriad Genetics. The company's fiscal 2020 first-quarter results reported in November were disastrous. Revenue fell 8% year over year. Myriad posted a net loss. Its adjusted earnings were well below Wall Street expectations.

However, the picture isn't as bleak as it might seem. The primary reason behind Myriad's weak financial performance is that a couple of key billing codes changed earlier this year. Myriad is feeling the negative impact of coding issues rather than lower demand for its flagship genomic tests for detecting breast cancer.

The company should get a nice boost from United Healthcare's decision to cover the GeneSight genetic test for helping identify the most effective treatment for depression. This coverage decision took effect on Oct. 1, 2019. Myriad expects that around 30% of tests won't meet the insurer's pre-authorization requirements, though, and is working to reduce the noncompliance rate. Myriad hopes to win positive coverage decisions from other payers for GeneSight and its Vectra molecular diagnostics test used to guide treatment for rheumatoid arthritis patients.

Other potential growth drivers for Myriad include its companion diagnostics products BRACAnalysis CDx and myChoice CDx. The company thinks that it will secure FDA approvals for BRACAnalysis CDx in pancreatic cancer and castrate-resistant metastatic prostate cancer. MyChoice CDx has already won FDA approval as a companion diagnostic for ovarian cancer drug Zejula. Myriad also expects to report results in 2020 from a clinical study evaluating myChoice CDX as a companion diagnostic for breast cancer. 

The company faces increased competition, though. There's also the potential that it might have to raise additional capital in the not-too-distant future: Myriad's cash stockpile stood at $142.6 million at the end of September.

Better buy

Both Exact Sciences and Myriad Genetics are viewed as growth stocks. However, one of these stocks is poised to deliver significantly more growth in the future -- Exact Sciences. I think this makes Exact Sciences the better pick over Myriad.

Keep in mind, though, that Exact Sciences stock price looks frothy based on its historical revenue. Shares currently trade at 19 times trailing-12-month sales. But with strong growth prospects ahead, Exact Sciences should be able to justify its premium valuation.

This article represents the opinion of the writer, who may disagree with the “official” recommendation position of a Motley Fool premium advisory service. We’re motley! Questioning an investing thesis -- even one of our own -- helps us all think critically about investing and make decisions that help us become smarter, happier, and richer.