HOLX vs. EXAS: Which Cancer Diagnostics Stock Should You Retain Now?

Amid the rising prevalence of cancer worldwide, significant strides have been made in the cancer diagnostics market to improve treatment outcomes and survival rates. According to Roots Analysis, the market is poised to see steady growth, driven by increasing demand for early cancer detection, technological advancements and the growing importance of personalized medicine. Companies like Hologic HOLX and Exact Sciences Corporation EXAS are drawing investors' attention for their strong positioning in this space.  

Hologic specializes in products and applications focused on women's health, with a strong presence in breast and cervical cancer care. Meanwhile, Exact Sciences offers a leading portfolio for earlier cancer detection and treatment decisions, with an established presence in colorectal cancer (CRC) screening and precision oncology.

Let’s find out which one currently presents a more compelling investment case. 

The Case for Hologic

A combination of organic and inorganic innovation continues to drive Hologic’s growth. Its largest division, Diagnostics, is led by the Molecular Diagnostics unit, supported by the growing use of the Panther and Panther Fusion platforms. More than 20 assays are now approved on the systems, which have a combined global installed base of more than 3,300. Molecular growth is driven by newer assays like the BV/CV/TV vaginitis test, along with acquired technologies from Biotheranostics. Hologic’s cytology business is experiencing strong momentum, thanks to the Genius digital cytology system.

In Breast Health, the company maintains a close to 80% share of the U.S. market with its 3D Genius mammography machine. Last year, Hologic acquired UK-based Endomagnetics, which expanded its capabilities in interventional breast surgery. Meanwhile, the recurring service business is seeing steady growth.

The Surgical division is led by the MyoSure and Fluent platforms for the treatment of fibroids. International growth is backed by the company’s market development efforts and awareness of minimally invasive GYN offerings. The Fluent Pro system is gaining traction, enhancing both the performance and user experience of MyoSure. The recent Gynesonics acquisition further bolsters the division.

However, Diagnostics may be affected by the loss of the HIV testing business in Africa due to USAID funding cuts. Breast Health is seeing softer capital equipment demand, but a return to growth is expected later this year. The company largely trimmed its China revenue outlook to minimize exposure to the region’s geopolitical risk.

In the second quarter of fiscal 2025, Hologic posted an operating margin of 30%, showing resilience even amid integrating two acquisitions. However, tariffs tied to its manufacturing operations are expected to raise inventory costs by $20 million-$25 million per quarter. Financially, Hologic has a fortress balance sheet, which backs its tuck-in M&A activity and share repurchases.

The Case for Exact Sciences

The company is in the middle of a transformative 2025. Cologuard —its flagship, non-invasive CRC screening test for average risk adults 45 years of age and older — is seeingbroad-based momentum fueled by rescreening success, care gap programs and growth in new ordering providers. In Precision Oncology, the Oncotype DX breast cancer test serves as a global standard of care and the most widely recommended in cancer guidelines. International adoption is robust, particularly in Japan, where the test secured reimbursement in 2023. 

Building on its successes, Exact Sciences is advancing its innovation pipeline for use before, during and after a cancer diagnosis. In March 2025, the company launched Cologuard Plus with Medicare coverage and quality measure guideline inclusion. The test has set a new benchmark with 95% CRC detection sensitivity at 94% specificity.

In April, EXAS introduced Oncodetect, a molecular residual disease (MRD) test that recently secured Medicare coverage for stage II, III and resectable stage IV CRC.  The company is set to enter the multi-cancer early detection (MCED) market with Cancerguard, expected to launch later this year as a laboratory-developed test.

Operational efficiency remains a key focus. In the first quarter, adjusted EBITDA rose 61% year over year, supported by productivity and cost-cutting initiatives. The company invested $25 million in cost-saving actions, targeting $18 million in annual savings, including $9 million in 2025. EXAS also faces minimal tariff impact, as all its manufacturing activities and lab work are U.S.-based. 

Financially, EXAS is well-positioned and is working to boost free cash flow through productivity and working capital initiatives. Still, high debt levels remain a concern. Factors such as inflation, currency fluctuations, and shifting macroeconomic and geopolitical conditions could also push up its operational costs.

EPS Projections for HOLX and EXAS

The Zacks Consensus Estimate for Hologic’s fiscal 2025 EPS implies a year-over-year improvement of 2.7% to $4.19. Estimates have been trending south in the last 90 days.

Meanwhile, the consensus EPS estimate for Exact Sciences stands at 16 cents for 2025, reflecting a 169.6% improvement. Analyst estimates have been trending bullish for the last 90 days.

Price Performance & Valuation: HOLX & EXAS

Over the past year, Hologic shares have fallen 15.9%, while Exact Sciences shares have gained 7.4%.

Hologic is currently trading at a forward three-year price-to-sales of 3.47X, lower than the industry’s 4.34X. Exact Sciences’ forward sales multiple sits at 2.76X.

Conclusion

Hologic’s businesses remain diversified and resilient, with several growth drivers supporting its long-term growth outlook. International Surgical performance is a strong tailwind, while a strong balance sheet offers strategic and financial flexibility. Still, broader economic and end-market pressures, as well as tariffs, could weigh on its overall performance. Exact Sciences is gaining from the ongoing Cologuard adoption, with its strong innovation pipeline poised to fuel growth in the coming years. While elevated debt may pose risks, its productivity and working capital initiatives are expected to generate stronger cash flows. Rising earnings estimates further add to its appeal.

Overall, EXAS appears to be a better pick at the moment. Hologic currently carries a Zacks Rank #4 (Sell), while Exact Sciences has a Zacks Rank #2 (Buy). You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.

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This article originally published on Zacks Investment Research (zacks.com).

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