Exact Sciences Soars with Cologuard Plus—Is This the Breakthrough Investors Have Been Waiting For?

The healthcare sector has been a rollercoaster for investors in 2025, but one name is standing out: Exact Sciences Corporation (EXAS). The Madison, Wisconsin-based company just delivered a Q1 earnings report that’s making Wall Street sit up and take notice. With revenue soaring 11%, a game-changing product launch, and a stock price that’s on fire, Exact Sciences is proving that innovation in cancer screening can still drive massive returns. Let’s dig into the numbers—and why this could be a must-own stock for the next 12 months.

The Numbers Don’t Lie: Revenue, Margins, and a New Era

Exact Sciences reported $707 million in Q1 revenue, a 11% year-over-year jump that outpaced even the most bullish estimates. But what’s truly exciting is the quality of this growth. The Screening segment, which houses its flagship Cologuard test, saw a 14% revenue surge to $540 million. This isn’t just about selling more tests—it’s about dominating a market.

The real star here is Cologuard Plus™, the next-gen colorectal cancer screening test launched this quarter. With 40% fewer false positives than the original Cologuard, this innovation is a game-changer. Medicare coverage and inclusion in HEDIS guidelines mean it’s now the go-to for millions of Americans. CEO Kevin Conroy dropped a bombshell during the call: “We’re nearing the point that more people will choose Cologuard in a year than colonoscopy.”

But it’s not just about screening. The Precision Oncology segment grew 4% on a core basis to $167 million, driven by demand for tests like Oncotype DX® and the new Oncodetect™ MRD test—which detects residual cancer DNA up to two years earlier than imaging. This isn’t incremental progress; it’s transformative.

The proof is in the margins. Adjusted EBITDA jumped 61% to $63 million, with a margin expanding to 9%—a staggering 280 basis point improvement. Free cash flow turned breakeven, a critical milestone for a company that’s been burning through cash in prior years.

The Stock’s On Fire—But Can It Keep Burning?

The market loved what it heard. Shares of EXAS rose 3.3% during regular trading on May 1, but the real fireworks came after hours: an 8.88% surge to $51.35, erasing months of losses in a single day.

Analysts are now revising their targets skyward. The company raised its full-year guidance to $3.07–3.12 billion in revenue (up $40 million from prior guidance) and $425–455 million in adjusted EBITDA. Even the net loss narrowed to $101 million, an $9 million improvement year-over-year.

But here’s the kicker: Exact Sciences is scaling without sacrificing growth. Its ExactNexus™ platform is streamlining operations, while its salesforce is expanding into high-potential provider markets. The Care Gap program, which targets underserved populations, is growing at a triple-digit pace—now contributing over 25% of total revenue.

Risks? Absolutely—but the Upside Outweighs Them

Every investment has risks. For EXAS, the big ones are:
1. Payer pushback: Medicare and private insurers could squeeze reimbursements for new tests.
2. Competitor pressure: Companies like Grail (owned by Illumina) and Guardant Health are racing to launch competing multi-cancer tests.
3. Execution: Scaling new products like Cancerguard™ (due late 2025) and getting FDA nods for Oncodetect’s expanded use will be critical.

Yet the positives are massive. The BLUE-C study for its blood-based colon cancer test—expected in mid-2025—could validate a product that’s even less invasive than Cologuard. And with $786 million in cash, Exact Sciences can weather short-term hiccups.

The Bottom Line: This Is a Buy—But Act Fast

Exact Sciences is in the midst of a strategic renaissance. It’s not just selling tests; it’s building a cancer detection ecosystem that spans screening, diagnosis, and monitoring. With margins expanding, cash flow improving, and a pipeline that’s firing on all cylinders, this is a company primed to dominate its space.

The stock’s post-earnings pop shows investors are buying in—but don’t wait too long. The next catalyst is clear: Cancerguard’s launch and BLUE-C data could send shares even higher.

If you’re looking for a healthcare stock with real growth, tangible products, and a CEO who’s not afraid to dream big, Exact Sciences is the play.

Final Call: EXAS is a Buy with a 12-month target of $65–$70. The pieces are falling into place—now’s the time to board this train.