Exact Sciences Corp (EXAS) 2023 Q2 法說會逐字稿

Good day, and welcome to the Exact Sciences' Second Quarter 2023 Earnings Call. Today's call is being recorded. (Operator Instructions). I would now like to turn the conference over to Megan Jones, Vice President of Investor Relations. Please go ahead.

美好的一天，歡迎參加 Exact Sciences 的 2023 年第二季度收益電話會議。今天的通話正在錄音。 （操作員說明）。我現在想將會議交給投資者關係副總裁梅根·瓊斯 (Megan Jones)。請繼續。

Thanks, Lisa. Thank you for joining us for Exact Sciences' Second Quarter 2023 Conference Call. On the call today are Kevin Conroy, the company's Chairman and CEO; and Jeff Elliott, our Chief Financial Officer. Everett Cunningham, our Chief Commercial Officer, will also be available for questions. Exact Science issued a news release earlier this afternoon detailing our second quarter financial results. This news release and today's presentation are available on our website at exactsciences.com.

謝謝，麗莎。感謝您參加 Exact Sciences 2023 年第二季度電話會議。今天參加電話會議的是該公司董事長兼首席執行官凱文·康羅伊 (Kevin Conroy)；和我們的首席財務官 Jeff Elliott。我們的首席商務官 Everett Cunningham 也將回答問題。 Exact Science 今天下午早些時候發布了一份新聞稿，詳細介紹了我們第二季度的財務業績。本新聞稿和今天的演示可在我們的網站 exactsciences.com 上獲取。

During today's call, we will make forward-looking statements based on current expectations. Our actual results may be materially different from such statements. Discussions of non-GAAP figures and reconciliations to GAAP figures are available in our earnings press release, and descriptions of the risks and uncertainties associated with Exact Sciences are included in our SEC filings. Both can be accessed through our website. I'll now turn the call over to Kevin.

在今天的電話會議中，我們將根據當前預期做出前瞻性陳述。我們的實際結果可能與此類聲明存在重大差異。我們的收益新聞稿中提供了對非 GAAP 數據的討論以及與 GAAP 數據的調節，並且與 Exact Sciences 相關的風險和不確定性的描述包含在我們向 SEC 提交的文件中。兩者都可以通過我們的網站訪問。我現在將電話轉給凱文。

Exact Sciences' world-class team is the driving force behind the most innovative growth engine in cancer diagnostics. Our scientists are using advanced technologies to harness the power of DNA, RNA and proteins. They are intensely focused on enhancing our current tests and developing new tests that can help transform cancer care. The scale of Exact Sciences' labs, IT infrastructure, commercial teams and our depth of payer relationships will help those tests impact millions of patients while providing profitable growth for years to come.

Exact Sciences 的世界一流團隊是癌症診斷領域最具創新性的增長引擎背後的驅動力。我們的科學家正在使用先進技術來利用 DNA、RNA 和蛋白質的力量。他們非常專注於增強我們當前的測試並開發有助於改變癌症護理的新測試。 Exact Sciences 實驗室的規模、IT 基礎設施、商業團隊以及我們與付款人關係的深度將有助於這些測試影響數百萬患者，同時在未來幾年提供盈利增長。

We made significant progress toward our mission to eradicate cancer during the second quarter, including being Great Place to Work certified for the fifth consecutive year, delivering more than 1 million test results to patients generating core revenue of $617 million, an improvement of $119 million year-over-year with an 18% decline in sales and marketing expense.

第二季度，我們在實現根除癌症的使命方面取得了重大進展，包括連續第五年獲得最佳工作場所認證，為患者提供超過100 萬份測試結果，核心收入達到6.17 億美元，同比增長1.19 億美元- 銷售和營銷費用同比下降 18%。

Producing $66 million of free cash flow, a $190 million improvement announcing positive top line results from our BLUE-C study, in which our next-generation Cologuard test exceeded our expectations for improved sensitivity and specificity, securing reimbursement for the Oncotype DX test in Japan and initiating collaborations with the Broad Institute to support our molecular residual disease test platform and Baylor Scott & White to support our Multicancer Early Detection program.

產生了6600 萬美元的自由現金流，改善了1.9 億美元，宣布我們的BLUE-C 研究取得了積極的頂線結果，其中我們的下一代Cologuard 測試超出了我們對提高靈敏度和特異性的預期，確保了日本Oncotype DX 測試的報銷並啟動與 Broad Institute 的合作以支持我們的分子殘留疾病測試平台，並與 Baylor Scott & White 合作以支持我們的多癌早期檢測計劃。

As a result of the outstanding results in the second quarter, we're raising our full year guidance for revenue by $54 million and adjusted EBITDA by $63 million. The second quarter results show our team's commitment to developing and enhancing tests that impact decision-making and supporting them with the highest quality evidence. Surrounded by a 2,000-person commercial and customer care organization, we'll provide the best customer experience for patients and their health care providers globally. This creates a flywheel that will power a unique combination of long-term double-digit growth and significant profitability.

由於第二季度的出色業績，我們將全年收入指導提高了 5400 萬美元，調整後 EBITDA 提高了 6300 萬美元。第二季度的結果表明，我們的團隊致力於開發和增強影響決策的測試，並以最高質量的證據支持決策。在擁有 2,000 名員工的商業和客戶服務組織的包圍下，我們將為全球患者及其醫療保健提供者提供最佳的客戶體驗。這創造了一個飛輪，將為長期兩位數增長和顯著盈利能力的獨特組合提供動力。

Jeff will now review our second quarter results.

傑夫現在將回顧我們第二季度的業績。

Thanks, Kevin. Second quarter revenue grew 19% to $622 million. Core revenue of $617 million grew 24%, excluding COVID testing, the sale of our prostate business and foreign exchange. Screening revenue of $463 million increased 31%. We continue to see broad-based momentum in Cologuard adoption and traction within health systems. Since the beginning of the year, we've implemented about 40 new electronic connections with large U.S. health systems, bringing the total to nearly 300. These connections allow health care professionals to order and view results seamlessly, and while giving patients access to results in Epic MyChart. They also enable electronic billing and reimbursement and in the future, automated prior authorizations, improving the efficiency of our teams and systems for Cologuard and our whole suite of tests.

謝謝，凱文。第二季度收入增長 19%，達到 6.22 億美元。核心收入為 6.17 億美元，增長 24%，其中不包括新冠病毒檢測、前列腺業務出售和外匯交易。放映收入達 4.63 億美元，增長 31%。我們繼續看到 Cologuard 在衛生系統中的採用和吸引力的廣泛勢頭。自今年年初以來，我們與美國大型醫療系統建立了約 40 個新的電子連接，使總數達到近 300 個。這些連接使醫療保健專業人員能夠無縫訂購和查看結果，同時讓患者能夠訪問結果史詩般的我的圖表。它們還支持電子計費和報銷，並在未來實現自動事先授權，從而提高 Cologuard 團隊和系統以及整套測試的效率。

More than 9,000 new health care professionals ordered Cologuard during the quarter and more than 321,000 ordered since launch. About 75% of all U.S. primary care physicians have ordered Cologuard. So we don't plan to provide the number of new physicians each quarter starting next year.

本季度有超過 9,000 名新醫療保健專業人員訂購了 Cologuard，自推出以來訂購量超過 321,000 名。大約 75% 的美國初級保健醫生已訂購 Cologuard。因此，我們不打算從明年開始每個季度提供新醫生的數量。

Precision Oncology revenue grew 2% to $157 million. Growth was 7%, excluding the prostate business sale and foreign exchange. COVID testing revenue decreased 84% to $2 million. Second quarter GAAP gross margin was 71%. Non-GAAP gross margin excluding amortization of acquired intangibles was 75%. Gross margin benefited from better cash collections due to improvements made to our billing systems.

精準腫瘤學收入增長 2%，達到 1.57 億美元。增長率為 7%，不包括前列腺業務銷售和外匯。 COVID 檢測收入下降 84% 至 200 萬美元。第二季度 GAAP 毛利率為 71%。不計收購無形資產攤銷的非公認會計準則毛利率為 75%。由於計費系統的改進，毛利率受益於更好的現金收款。

GAAP net loss was $81 million. Adjusted EBITDA was $67 million, an improvement of $113 million, driven by better-than-expected revenue, gross margin and operating expense discipline. Cash provided by operating activities was $100 million. Free cash flow was $66 million, an improvement of $190 million. We ended the quarter with cash and securities of $776 million.

GAAP 淨虧損為 8100 萬美元。受好於預期的收入、毛利率和運營費用約束的推動，調整後 EBITDA 為 6700 萬美元，增加了 1.13 億美元。經營活動提供的現金為1億美元。自由現金流為 6,600 萬美元，增加了 1.9 億美元。本季度結束時，我們擁有 7.76 億美元的現金和證券。

Turning to guidance, we expect total revenue between $605 million and $620 million during the third quarter and $2.441 billion and $2.466 billion for the year. This assumes screening revenue between $455 million and $465 million for the third quarter and between $1.82 billion and $1.835 billion for the year.

至於指引，我們預計第三季度總收入將在 6.05 億美元至 6.2 億美元之間，全年總收入將在 24.41 億美元至 24.66 億美元之間。假設第三季度的放映收入在 4.55 億美元至 4.65 億美元之間，全年的放映收入在 18.2 億美元至 18.35 億美元之間。

Precision Oncology revenue between $150 million and $155 million for the third quarter and between $615 million and $625 million for the year; and COVID revenue of $6 million for the year. Note that we discontinued COVID testing in July. For the year, guidance implies 22% core revenue growth with 28% growth in screening and 6% growth in Precision Oncology. We're increasing our adjusted EBITDA guidance for the year to between $170 million and $180 million, up $163 million (sic) [$63 million] from the start of the year.

第三季度精準腫瘤學收入在 1.5 億美元至 1.55 億美元之間，全年收入在 6.15 億美元至 6.25 億美元之間；今年的新冠肺炎收入為 600 萬美元。請注意，我們於 7 月份停止了新冠病毒檢測。今年的指導意味著核心收入增長 22%，其中篩查增長 28%，精準腫瘤學增長 6%。我們將今年調整後的 EBITDA 指導值提高到 1.7 億美元至 1.8 億美元之間，比年初增加了 1.63 億美元（原文如此）[6,300 萬美元]。

The Exact Sciences platform was built to drive double-digit revenue growth and margin improvement for years. Second quarter shows this engine is earning potential. Back to you, Kevin.

Exact Sciences 平台的建立是為了多年來推動兩位數的收入增長和利潤率提高。第二季度顯示該引擎具有盈利潛力。回到你身上，凱文。

Thanks, Jeff. Cologuard is helping to screen more Americans and reduce the suffering from colon cancer. Next-generation Cologuard will raise the performance bar in noninvasive screening and accelerate its positive impact. Next-generation Cologuard achieved a 30% improvement in specificity, a measure of the false positive rate while improving sensitivity for the cancer and precancer detection rates. This is a result of advanced technology, deep scientific insights and more than a decade of collaboration between our R&D team and Mayo Clinic. We are proud of our teams for their efforts to bring next-generation Cologuard to patients. We're finalizing the FDA submission, and we're working to get it in patients' hands in early 2025.

謝謝，傑夫。 Cologuard 正在幫助篩查更多的美國人並減少結腸癌的痛苦。下一代 Cologuard 將提高無創篩查的性能標準並加速其積極影響。新一代 Cologuard 的特異性（假陽性率衡量標準）提高了 30%，同時提高了癌症的敏感性和癌前病變檢出率。這是先進技術、深刻的科學見解以及我們的研發團隊與梅奧診所十多年來合作的結果。我們為我們的團隊為患者帶來下一代 Cologuard 所做的努力感到自豪。我們正在完成向 FDA 提交的申請，並努力在 2025 年初將其交付給患者。

Once next-generation Cologuard is FDA approved, it will be supported by the best commercial team in diagnostics and the most dedicated frontline team members. This team has worked tirelessly to build relationships with health care professionals, connections to hospitals and a strong brand. This is a big opportunity to have an impact on this disease because 60 million people are not up to date with colon cancer screening in the U.S.

一旦下一代 Cologuard 獲得 FDA 批准，它將得到診斷領域最好的商業團隊和最敬業的一線團隊成員的支持。該團隊孜孜不倦地努力與醫療保健專業人員建立關係、與醫院建立聯繫並建立強大的品牌。這是對這種疾病產生影響的絕佳機會，因為美國有 6000 萬人沒有及時接受結腸癌篩查。

With our team's commitment to getting more people screened in a more accurate test, Cologuard will help improve colon cancer outcomes and continue to fuel our growth. Our Precision Oncology team secured reimbursement for the Oncotype DX breast test in Japan where 90,000 women are diagnosed with breast cancer every year. About half of them are eligible for Oncotype DX making Japan the biggest opportunity outside the U.S. With reimbursement now in place, Oncotype DX can provide important answers to women who aren't currently being tested. Our team in Japan will work to educate doctors, hospitals and communities about the value of genomic testing with Oncotype DX. So more women and their physicians can make better personalized treatment decisions. A special thanks to the international team who is bringing this important innovation to patients in Japan.

我們的團隊致力於讓更多的人通過更準確的測試進行篩查，Cologuard 將幫助改善結腸癌的結果並繼續推動我們的增長。我們的精準腫瘤學團隊在日本獲得了 Oncotype DX 乳房測試的報銷，日本每年有 90,000 名女性被診斷患有乳腺癌。其中大約一半有資格接受 Oncotype DX，使日本成為美國以外最大的機會。隨著報銷現已到位，Oncotype DX 可以為目前尚未接受測試的女性提供重要答案。我們在日本的團隊將致力於向醫生、醫院和社區宣傳 Oncotype DX 基因組檢測的價值。因此，更多的女性及其醫生可以做出更好的個性化治療決策。特別感謝國際團隊為日本患者帶來了這一重要的創新。

Our pipeline teams are focused on 2 of the biggest opportunities in cancer [diagnostics], molecular residual disease and multicancer early detection. We're working with the Broad Institute to enhance and extend our molecular residual disease platform called oncodetect with an exclusive license to technology development at the Broad. Will move from whole exon to whole genome sequencing and from looking at 50 to 100 mutations in a patient's blood to hundreds, if not thousands of mutations. This will provide best-in-class performance at a very reasonable cost point, allowing us to reach cancer patients at scale.

我們的管道團隊專注於癌症[診斷]、分子殘留疾病和多癌早期檢測領域的兩個最大機會。我們正在與 Broad Institute 合作，增強和擴展我們名為 oncodetect 的分子殘留疾病平台，並獲得 Broad Institute 的技術開發獨家許可。將從全外顯子測序轉向全基因組測序，從觀察患者血液中的 50 到 100 個突變轉向數百個甚至數千個突變。這將以非常合理的成本提供一流的性能，使我們能夠大規模接觸癌症患者。

Our multi-cancer early detection team is working to complete the ASCEND 2 trial which will validate our multi-marker class approach in a large case control study, including 21 cancer types. We expect to have partial results from the ASCEND 2 study this fall with a full readout early next year. We're generating additional data to support discussions with regulatory agencies, guideline bodies and payers, helping secure access to this life-changing innovation for all patients.

我們的多癌症早期檢測團隊正在努力完成 ASCEND 2 試驗，該試驗將在一項大型病例對照研究（包括 21 種癌症類型）中驗證我們的多標記類別方法。我們預計將在今年秋季獲得 ASCEND 2 研究的部分結果，並於明年初獲得完整結果。我們正在生成更多數據來支持與監管機構、指南機構和付款人的討論，幫助所有患者獲得這一改變生活的創新。

Our focus on eradicating cancer fuels the Exact Sciences' team and is driving our financial results. We'll continue to invest in our people, reaching more patients with our current tests and developing new cancer diagnostic tests. Our scale platform will accelerate adoption of our tests while sustaining double-digit revenue growth, improving operating leverage and meaningful cash flow for years. This is a rare opportunity to reduce the suffering cancer causes while delivering value to our shareholders. We're just getting started. We're now happy to answer your questions.

我們對根除癌症的關注為 Exact Sciences 團隊提供了動力，並推動了我們的財務業績。我們將繼續投資於我們的員工，通過我們當前的測試覆蓋更多患者，並開發新的癌症診斷測試。我們的規模平台將加速我們測試的採用，同時保持兩位數的收入增長，提高運營槓桿和有意義的現金流。這是一個難得的機會，可以減少癌症帶來的痛苦，同時為我們的股東創造價值。我們才剛剛開始。我們現在很高興回答您的問題。

(Operator Instructions) We'll take our first question from Derik De Bruin with Bank of America.

（操作員說明）我們將回答美國銀行 Derik De Bruin 提出的第一個問題。

So I'm going to do 2, one financial question. Jeff, how should we think about OpEx trending in the back half of the year? And the other one, just how do you think Cologuard 2.0 will be a tailwind? How much of the tailwind do you think will be once FD approved, I mean, are there docs now that were more likely to use 2.0 that were not using 1.0. Just sort of your thoughts on how that rolls off and how that impacts the business?

所以我要回答 2 個財務問題。 Jeff，我們應該如何看待下半年的運營支出趨勢？另一個問題是，您認為 Cologuard 2.0 將如何成為推動因素？您認為一旦 FD 獲得批准，將會有多大的順風，我的意思是，現在是否有文檔更有可能使用 2.0 而不是使用 1.0。您對如何開展以及如何影響業務有何看法？

Derik, this is Jeff. I'll take the first one on OpEx. Look, for the year, no change to the assumptions there, which is an overall increase in the mid-single-digit range. The way you get there is really continued good management by Everett and team. We expect sales and marketing decline for the year in total. R&D up probably in the mid-single-digit range.

德里克，這是傑夫。我將選擇 OpEx 上的第一個。看起來，今年的假設沒有變化，總體增長在中個位數範圍內。埃弗雷特和團隊的持續良好管理是您實現這一目標的真正秘訣。我們預計今年的銷售和營銷總額將下降。研發增長可能在中個位數範圍內。

G&A, as you remember back in the start of the year, we talked there, there are some kind of moving pieces here related to primarily the Thrive earnout. That is driving a big part to the growth this year. If you strip out that, which is noncash now, obviously, the payout would be several years into the future. If you strip out that and some other kind of unique onetime items, the growth there is also in the mid-single digits.

G&A，正如您所記得的那樣，在今年年初，我們在那裡討論過，這裡有一些主要與 Thrive 收益相關的活動。這對今年的增長起到了很大的推動作用。如果你把它去掉，顯然，現在它是非現金的，支付將在未來幾年後發生。如果你剔除這個和其他一些獨特的一次性項目，那裡的增長也是中等個位數。

So what that implies here for the back half is a bit of an increase in the second half versus the first half? As you recall, last call -- last quarter, we talked about accelerating some investments in MRD, given how quickly that market is moving forward and given our confidence in our technology and our approach there. Also with the growth that we've had hiring is going to pick up in the back half of the year, really to help support that continued growth. I think there's 2 questions there. I'll turn it over to Everett for the second one.

那麼，這對於後半場來說意味著下半場與上半場相比有所增加嗎？您還記得，在上個季度的最後一次電話會議上，我們談到了加快對 MRD 的一些投資，考慮到該市場發展的速度以及我們對我們的技術和方法的信心。此外，隨著我​​們的招聘增長將在今年下半年回升，這確實有助於支持持續增長。我認為有兩個問題。我會把第二份交給埃弗雷特。

Yes. Thanks, Jeff. And you talked about the strategy of Cologuard 2.0. Our first focus will be continuing to grow Cologuard until Cologuard 2.0 gets FDA approved. The great thing about our field forces were driven by data and analytics. And we use that daily in which we make our sales calls and we take notes on our sales calls. So we know which physicians that are out there that had the objection of, hey, the false positive rate is an objection. So once we do launch Cologuard 2.0, we will focus on going to those physicians first, and that's just the power of our commercial organization, the data and analytics that we use to go to the right targets with the right message and the commercial team is excited to get Cologuard 2.0 in their [bag].

是的。謝謝，傑夫。您談到了Cologuard 2.0的策略。我們的首要重點將是繼續發展 Cologuard，直到 Cologuard 2.0 獲得 FDA 批准。我們現場部隊的偉大之處在於數據和分析。我們每天都會使用它來進行銷售拜訪，並在銷售拜訪中做筆記。所以我們知道哪些醫生提出了反對意見，嘿，假陽性率是一個反對意見。因此，一旦我們推出 Cologuard 2.0，我們將首先關注這些醫生，這就是我們商業組織的力量，我們使用數據和分析來向正確的目標傳遞正確的信息，商業團隊是很高興能將Cologuard 2.0 裝進他們的[包]。

We'll take our next question from Catherine Schulte with Baird.

我們將回答凱瑟琳·舒爾特和貝爾德提出的下一個問題。

I guess maybe Everett, another one for you. Jeff mentioned that about 75% of primary care doctors in the U.S. ordered Cologuard. So I guess just how does your strategy change now that the primary focus will be on really deepening the penetration within accounts rather than adding new orders? And would love any examples you could give there?

我想埃弗雷特可能是另一位給你的。 Jeff 提到，美國約 75% 的初級保健醫生訂購了 Cologuard。因此，我想您的策略現在將如何改變，因為主要重點將是真正加深帳戶內的滲透而不是增加新訂單？希望您能提供一些例子嗎？

Yes. Thanks for that question. We're not complacent at all with that number. We have 10% penetration with Cologuard. So we know that along with the 60 million Americans that -- of average risk that right now are not up to date with screening. So our commercial organization goes out every day knowing that there's opportunities that are out there to continue to grow Cologuard. That's our focus.

是的。謝謝你提出這個問題。我們對這個數字一點也不沾沾自喜。 Cologuard 的滲透率為 10%。所以我們知道，與 6000 萬美國人一樣，目前處於平均風險的人還沒有及時進行篩查。因此，我們的商業組織每天都在外出，因為他們知道存在繼續發展 Cologuard 的機會。這是我們的重點。

And like I said before, we use data and analytics to not just concentrate on the reach of the physician, but we need to concentrate on the frequency and making sure that we get the message out there consistently. Because we know that there's more work to do to get our customers out there to write more Cologuard and get more people screened.

正如我之前所說，我們使用數據和分析不僅要關注醫生的影響力，而且需要關注頻率並確保我們始終如一地傳達信息。因為我們知道，要讓我們的客戶編寫更多 Cologuard 並讓更多人接受篩查，還需要做更多的工作。

We'll take our next question from Vijay Kumar with Evercore ISI.

我們將接受 Evercore ISI 的 Vijay Kumar 提出的下一個問題。

Jeff, maybe I'll just limit one to the profitability question. You did adjusted EBITDA of $130 million in the first half, your second half revenues on a dollar basis, we don't change a whole lot. I think the guide implies like 70-ish of EBITDA for the back half. Maybe talk about your incremental margins, incremental leverage here you did mention G&A had some noise on earnouts. When can we actually see G&A leverage similar to what we're seeing on the sales and marketing side?

傑夫，也許我會只討論盈利能力問題。上半年調整後的 EBITDA 為 1.3 億美元，下半年的收入以美元為基礎，我們沒有做太多改變。我認為該指南暗示後半部分的 EBITDA 約為 70 左右。也許談談你的增量利潤、增量槓桿，你確實提到了 G&A 對盈利有一些噪音。我們什麼時候才能真正看到與銷售和營銷方麵類似的一般管理費用槓桿？

Thanks, Vijay. A lot there. I think we feel really good about the state of this business, especially the foundation we've talked so much about. The foundation was built to scale, built to scale the top line and drive margin improvement and cash flow improvement for years to come. And that foundation allowed us to pull in profitability late last year and accelerate time to free cash flow positivity this quarter. So we feel good about the long-term prospects there.

謝謝，維杰。那裡有很多。我認為我們對這項業務的狀況感到非常滿意，尤其是我們已經談論了很多的基金會。該基金會是為了擴大規模而建立的，旨在擴大收入並推動未來幾年利潤率的提高和現金流的改善。這一基礎使我們能夠在去年年底實現盈利，並在本季度加快實現自由現金流的速度。因此，我們對那裡的長期前景感到樂觀。

Take a step back here, what we're guiding to for the year now is a $320 million rough improvement year-on-year. in adjusted EBITDA. But when you compare that to the level of growth, it implies very strong adjusted EBITDA margins that we feel good about. When you look at the guidance raised specifically, the midpoint of adjusted EBITDA is coming up by more at $63 million from the midpoint of revenue. So we are driving that leverage.

退一步來說，我們今年的目標是同比粗略改善 3.2 億美元。調整後的 EBITDA。但當你將其與增長水平進行比較時，它意味著調整後的 EBITDA 利潤率非常強勁，我們對此感到滿意。當您具體查看提出的指導意見時，會發現調整後 EBITDA 的中點比收入中點增加了 6300 萬美元。因此，我們正在推動這一槓桿作用。

To your question around G&A, in the quarter, there were a couple of one-timers, a legal settlement of $17 million that's in the press release and also I mentioned before the Thrive acquisition earnout. Again, it's a noncash accretion line that can flip back and forth between the gain and expense quarter-to-quarter. If you strip those 2 things out, G&A grew 2% in the quarter. So I think the team did a good job managing that relative to the 19% year-on-year growth in revenue. Still some work to be done in G&A, but with this foundation we have in place, we expect that number to come down as a percent of revenue nicely over time.

對於你關於 G&A 的問題，本季度出現了一些一次性事件，新聞稿中提到了 1700 萬美元的法律和解，我在 Thrive 收購收益之前也提到過。同樣，這是一條非現金增長線，可以按季度在收益和支出之間來回翻轉。如果剔除這兩件事，本季度的 G&A 增長了 2%。因此，我認為相對於收入同比增長 19% 而言，團隊在管理方面做得很好。 G&A 方面仍有一些工作要做，但有了這個基礎，我們預計隨著時間的推移，這個數字佔收入的百分比會很好地下降。

We'll take our next question from Dan Brennan with TD Cowen.

我們將回答 Dan Brennan 和 TD Cowen 提出的下一個問題。

Congrats. Maybe just on Cologuard. I guess could you walk through some color on some of the notable drivers there, the rescreen in the 45 to 49, kind of did you see any impact from that 3-year look back where you had the COVID quarter 3 years ago on the rescreen. Just wondering how those 2 played out in the quarter. And then as well, obviously, you've talked about only 10% penetration, but momentum has been really strong on clearing the backlog of colonoscopies and kind of the health systems, electronic orders. So just give a little flavor for how a lot of those key drivers played out in the quarter and kind of what's assumed for the back half of the year.

恭喜。也許只是在 Cologuard 上。我想你能否對一些著名的司機進行一些分析，在 45 到 49 的重新篩選中，你是否看到了 3 年回顧中 3 年前的新冠季度重新篩選產生的影響？ 。只是想知道這兩個人在本季度的表現如何。顯然，您談到的滲透率只有 10%，但在清理積壓的結腸鏡檢查和醫療系統、電子訂單方面的勢頭非常強勁。因此，請稍微了解一下許多關鍵驅動因素在本季度的表現以及對今年下半年的假設。

Dan, this is Jeff. I'll start and then Everett can jump in with some color. The beauty of this business is that there's a broad-based set of drivers here. So there's not just 1 or 2, it is broad. Rescreen is a big we've talked about. Rescreening are growing nicely. We do have that headwind, the team is managing through. And the headwind here is because Cologuard is recommended by the guidelines to be done every 3 years.

丹，這是傑夫。我先開始，然後埃弗雷特可以加入一些顏色。這項業務的美妙之處在於這裡有基礎廣泛的驅動因素。所以不只是一兩個，它是廣泛的。重新篩選是我們談論過的一件大事。重新篩選增長良好。我們確實遇到了逆風，球隊正在克服。這裡的不利因素是因為指南建議每 3 年進行一次 Cologuard。

Three years ago, obviously, was the onset of COVID. And Cologuard orders were negatively impacted, especially in the early days of COVID. So you think back to April, May, June 2020, Cologuard orders were actually down. They did recover nicely. What that means now 3 years later, when people are coming up to that rescreen, there is an impact on the business. The total number of patients eligible for rescreen this year that 3-year repeat is 1.2 million. That's the same as last year. The good news is when you look ahead to next year, it jumps to 1.6 million.

顯然，三年前是新冠疫情爆發的時候。 Cologuard 訂單受到了負面影響，尤其是在新冠疫情爆發初期。所以你回想一下 2020 年 4 月、5 月、6 月，Cologuard 訂單實際上有所下降。他們確實恢復得很好。這意味著三年後，當人們進行重新篩選時，會對業務產生影響。今年有資格進行三年重複篩查的患者總數為 120 萬人。這和去年一樣。好消息是，展望明年，這一數字將躍升至 160 萬。

So this is a temporary slowdown in that rescreen growth. Again, the team is doing a good job of managing through it. So we are driving growth here. Just to think about the size of the headwinds. For the year, it's over $50 million of revenue. Again, the headwind, it is temporary. A big part of that hits in Q3. So again, team is driving through that. Other drivers, things like Cologuard 45, this new age group that is now part of the guidelines. A couple of years ago, the guidelines lowered from 50 down to age 45 to adding 20 million more people that age group is approaching 20% of all Cologuard revenue. So a huge driver there. Everett can talk more about health systems. But the good news here is that there's a broad set of drivers here that we expect to continue for many years to come.

因此，這是重新篩選增長的暫時放緩。同樣，團隊在管理方面做得很好。因此，我們正在推動這裡的增長。只要想想逆風的大小。今年的收入超過 5000 萬美元。再說一遍，逆風是暫時的。其中很大一部分發生在第三季度。再說一遍，團隊正在努力解決這個問題。其他車手，例如 Cologuard 45，這個新年齡組現已成為指南的一部分。幾年前，指導方針從 50 歲降低到 45 歲，增加了 2000 萬人，該年齡組接近佔 Cologuard 總收入的 20%。所以那裡有一個巨大的司機。埃弗里特可以更多地談論衛生系統。但好消息是，這裡有一系列廣泛的驅動因素，我們預計這些驅動因素將持續很多年。

Yes. Thanks, Jeff. I will touch on rescreening 45 to 49 in health systems. This is just a great example of the way our commercial team is working together and they treated as a team sport from our marketing messages specific to 45 to 49 in rescreen, our customer experience around those drivers of rescreening 45 to 49 and our training. We continue to hone our message around this. The data and analytics that we're using at the territory level in terms of the targets to go through to -- to grow these 2 type of growth levers has been tremendous. And I've been out in the field and it just gets better every quarter.

是的。謝謝，傑夫。我將談到衛生系統中 45 至 49 的重新篩查。這只是我們商業團隊合作方式的一個很好的例子，他們將我們針對45 至49 重新篩選的營銷信息、我們圍繞45 至49 重新篩選的驅動因素的客戶體驗以及我們的培訓視為一項團隊運動。我們將繼續圍繞這一點完善我們的信息。我們在地區層面使用的數據和分析，以實現這兩種類型的增長槓桿的目標，是巨大的。我一直在這個領域，每個季度都會變得更好。

As far as health systems, we're seeing a trend of health systems coming to us to help them with getting people screened for colorectal cancer screening. They're getting measured by it, and they know that they can't do it alone with colonoscopy only. And we're developing broader partnerships around those people of average risk that need to get screening and that have a colonoscopy backlog, they're coming to us for help around getting those patient screen.

就衛生系統而言，我們看到衛生系統的趨勢是向我們求助，幫助他們對人們進行結直腸癌篩查。他們正在通過它進行測量，並且他們知道僅靠結腸鏡檢查無法單獨做到這一點。我們正在圍繞那些需要接受篩查且有結腸鏡檢查積壓的平均風險人群建立更廣泛的合作夥伴關係，他們向我們尋求有關患者篩查的幫助。

And then lastly, I'll just say our brand, not just around Cologuard, but around Oncotype DX, around our rare diseases and PreventionGenetics, our brand is solid, and they know that they can come to us for help. So...

最後，我只想說我們的品牌，不僅圍繞 Cologuard，而且圍繞 Oncotype DX、圍繞我們的罕見疾病和 PreventionGenetics，我們的品牌是穩固的，他們知道他們可以向我們尋求幫助。所以...

We'll take our next question from Brandon Couillard with Jefferies.

我們將回答布蘭登·庫亞爾和杰弗里斯提出的下一個問題。

Jeff, 2 for you. The Oncotype approval in Japan, will that be a material incremental revenue contributor in the back half? Or was that more a '24 dynamic? And then the improved cash collection, is that a material benefit to screening revenue growth of 31% in the quarter? And so, can you call that out.

傑夫，2個給你。 Oncotype 在日本獲得批准，這會成為下半年實質性的增量收入貢獻者嗎？或者這更像是 24 世紀的動態？那麼，現金收集的改善是否會對本季度放映收入增長 31% 帶來實質性好處？那麼，你能說出來嗎？

Sure. Brandon. This is Jeff. The first one on Oncotype, really proud of what the team did to make sure we got reimbursement and access to this test to help out, as Kevin talked about, a significant number of women in Japan, which really -- when you look at the size of this market, it could be our largest market outside the U.S. In the first full year, the revenue run rate could be in the $25 million to $30 million range. Obviously, with the time this is coming on this year, we'd expect maybe 1/4 of that given when this is going to launch. So a small contributor this year but a very nice contributor over time. And importantly, a big win for patients.

當然。布蘭登.這是傑夫。 Oncotype 上的第一個，對團隊所做的工作感到非常自豪，確保我們獲得報銷並獲得這項測試的機會，以幫助日本大量女性，正如凱文所說，當你看到就這個市場的規模而言，它可能是我們在美國以外最大的市場。在第一個全年中，收入運行率可能在2500 萬美元到3000 萬美元之間。顯然，隨著今年的時間的推移，我們預計這可能是即將推出時的 1/4。因此，今年的貢獻者很小，但隨著時間的推移，貢獻者非常好。重要的是，這對患者來說是一個巨大的勝利。

Second one on the ASP revenue per test. As you know, Brandon, there's a lot of moving pieces when it comes to calculate an ASP there is the true run rate that you accrue for on a quarter. Think of this as your go-forward rate. The team has done a really nice job driving that rate higher over time and we'll continue to do so. I think Cologuard provides really good value and we want to make sure that we're getting paid fairly for that.

第二個是關於每次測試的 ASP 收入。布蘭登，正如您所知，在計算平均售價時，有很多變化因素，即您在一個季度累積的真實運轉率。將此視為您的前進率。該團隊做得非常出色，隨著時間的推移，該比率不斷提高，我們將繼續這樣做。我認為 Cologuard 提供了非常好的價值，我們希望確保我們得到公平的報酬。

What happened in the quarter was in part going back on tests that were previously denied payment on and making sure that we could get paid on that because, obviously, we have done the work. So pulling through revenue from past quarters, it wasn't material in the quarter. I did call it out because it's a nice contributor, but not a material driver -- it was in the first half of the year, it's over $10 million of revenue. When you compare that to the back half of the year, expect maybe $5 million of contribution. So first half, second half, there is a dynamic there, but again, not material to Q2.

本季度發生的事情在一定程度上是回顧了之前被拒絕付款的測試，並確保我們能夠獲得報酬，因為顯然我們已經完成了工作。因此，從過去幾個季度的收入來看，本季度的收入並不重要。我確實指出了這一點，因為它是一個很好的貢獻者，但不是一個物質驅動因素——它是在今年上半年，它的收入超過了 1000 萬美元。當你將其與今年下半年進行比較時，預計貢獻可能為 500 萬美元。所以上半場、下半場都有活力，但同樣，這對第二季度來說並不重要。

We'll take our next question from Patrick Donnelly with Citi.

我們將回答花旗集團帕特里克·唐納利 (Patrick Donnelly) 提出的下一個問題。

Jeff, maybe one just on kind of the seasonality and pacing of the year. I think the guidance for 3Q assumes screening is kind of flat, maybe even slightly down. It's been weird a couple of years with COVID in terms of seasonality of the business. Can you maybe just refresh us in terms of the typical pacing? Obviously, 4Q, you get the holidays and into 1Q, but just feels a little conservative in terms of that 3Q guidance. Maybe just talk us through that and how we should think about the year.

傑夫，也許只是關於一年中的季節性和節奏。我認為第三季度的指導假設放映量持平，甚至可能略有下降。就業務的季節性而言，這幾年的新冠疫情一直很奇怪。您能否讓我們了解一下典型的節奏？顯然，第四季度，你會享受假期並進入第一季度，但就第三季度的指導而言，感覺有點保守。也許只是告訴我們這一點以及我們應該如何思考這一年。

Let me start with overall kind of what the seasonality should look like, and then we'll get into this year specifically. So in a normal year, and this is a trend that's really general to primary care, not necessarily Cologuard specifically, primary care trends typically start the year slow as people come back from the holidays early January, a few people go out and get -- seek primary care. They're typically busy with work and their lives after the holidays. And then throughout that first quarter, things pick up all the way through Memorial Day things, people start to normalize care seeking behavior and really preventative care through that first part of the year.

讓我從整體的季節性應該是什麼樣子開始，然後我們將具體討論今年。因此，在正常的一年中，這是初級保健中普遍存在的趨勢，不一定是 Cologuard 特有的，初級保健趨勢通常在人們從一月初的假期回來時緩慢開始，一些人出去並得到 -尋求初級保健。假期過後，他們通常忙於工作和生活。然後在整個第一季度，事情在陣亡將士紀念日期間一直在好轉，人們開始在今年上半年使尋求護理的行為和真正的預防性護理正常化。

When Memorial Day hits, kids often get off a school and families take vacations, even people without kids often go on vacations. So trends typically are a little bit softer, I think of flattish trends throughout the summer. Then about mid-August, maybe end of August, things tick back up as kids come back to school and vacations start to wind down. So growth in primary [care] typically picks back up then and ramp steeply through November and then with Thanksgiving, things slowdown and are fairly quiet into the holidays.

當陣亡將士紀念日到來時，孩子們通常會放學，家庭也會去度假，甚至沒有孩子的人也會去度假。因此，趨勢通常會稍微溫和一些，我認為整個夏季的趨勢都是平淡的。然後大約八月中旬，也許是八月底，隨著孩子們回到學校，假期開始逐漸結束，事情又開始恢復。因此，初級護理的增長通常會在 11 月回升，並在 11 月急劇上升，然後到了感恩節，情況就會放緩，並在假期期間相當平靜。

For Cologuard now, remember, there's a -- think of about a 30-day time frame from the time a test is ordered at the -- during the physical when at the doctor's office to win them, it takes us then 30 days roughly to send the kit out, collect that patient sample, get the sample back in our lab, process it and recognize revenue. So that means that we follow a similar trend of typical primary care with a 30-day lag. This year, the dynamic to think about, it really comes down to that COVID headwind I mentioned before. COVID headwind on that 3-year rescreen business that I talked about a few minutes ago, that's $50 million for the year. The biggest part of that, the single biggest quarter is Q3. Q2 picked up some. Q4 picks up some, but Q3 is the biggest.

現在，對於 Cologuard，請記住，有一個 - 想想從在醫生辦公室下令進行測試之日起大約 30 天的時間範圍 - 在醫生辦公室進行體檢時要贏得他們，我們大約需要 30 天發送試劑盒，收集患者樣本，將樣本帶回我們的實驗室，對其進行處理並確認收入。因此，這意味著我們遵循典型初級保健的類似趨勢，但有 30 天的滯後。今年，要思考的動態，實際上可以歸結為我之前提到的新冠逆風。我幾分鐘前談到的那項為期 3 年的重新篩選業務面臨著新冠疫情的逆風，該業務全年價值 5000 萬美元。其中最大的部分，最大的一個季度是第三季度。第二季度有所上升。第四季度有所回升，但第三季度是最大的。

The other dynamic is that we did have a strong start to the year. I mentioned the kind of the ASP benefit over $10 million in the first half coming down to maybe 5 million in the second half. So that's going to affect the seasonal trends this year. But if you take a step back further, you look at the overall guide for the year. We're talking about $400 million of incremental growth for Cologuard. That's there for screening. That is the biggest year we've ever had. In terms of percentage growth, we're talking 28% growth at the midpoint. So very strong growth throughout the year for our screening business.

另一個動力是我們今年確實有一個強勁的開局。我提到上半年的 ASP 收益超過 1000 萬美元，下半年可能會下降到 500 萬美元。這將影響今年的季節性趨勢。但如果你退一步，你會看到今年的總體指南。我們談論的是 Cologuard 4 億美元的增量增長。那是為了篩選。那是我們經歷過的最重要的一年。就增長率而言，我們談論的是中點 28% 的增長率。我們的放映業務全年增長非常強勁。

We will take our next question from Dan Arias with Stifel.

我們將回答 Dan Arias 和 Stifel 提出的下一個問題。

On MRD oncodetect, Kevin, you had talked at the Analyst Day about an early access launch, I believe in 4Q, at the risk of being too granular here on timing, do you see that taking place in the fall rather than closer to the holidays, and the reason I ask the question is just really to sort of understand whether ASCO GI can see having someone that can speak to be an early user or at least being made aware of the assay to your point, the market is just evolving so quickly. I'm just thinking about clinician feedback and data points around early use.

在 MRD oncoDetect 上，Kevin，您在分析師日談到了早期訪問發布，我相信在第四季度，冒著時間上過於細粒度的風險，您是否認為這發生在秋季而不是接近假期，我問這個問題的原因只是為了了解ASCO GI 是否可以看到有人可以成為早期用戶，或者至少讓您了解您的觀點，市場發展得如此之快。我只是在考慮臨床醫生的反饋和有關早期使用的數據點。

Yes. We expect the MRD test to be available by the end of the year, so I would think later in the fourth quarter than earlier. And then it's going to take a little bit of time to get physician feedback given that we don't expect until kind of mid to third quarter of next year apply for MolDX local coverage decision, and then it typically takes about 6 months to get that. So in terms of being able to offer our oncodetect test to patients covered by Medicare, that will take about a year. And also, as you know, our commercial payers today aren't broadly covering MRD. So this is an opportunity that is going to take a little bit of time to play out. We're bringing to patients and to physicians the very best test possible with the right evidence.

是的。我們預計 MRD 測試將在今年年底推出，所以我認為第四季度晚些時候會比早些時候推出。然後需要一點時間才能獲得醫生的反饋，因為我們預計要到明年中期到第三季度才會申請 MolDX 本地承保決定，然後通常需要大約 6 個月的時間才能得到反饋。因此，就能夠向醫療保險覆蓋的患者提供我們的腫瘤檢測測試而言，這大約需要一年的時間。而且，如您所知，我們今天的商業付款人並未廣泛涵蓋 MRD。因此，這是一個需要一些時間才能發揮作用的機會。我們正在為患者和醫生提供具有正確證據的最佳測試。

We'll take our next question from Jack Meehan with Nephron Research.

我們將回答 Nephron Research 的 Jack Meehan 提出的下一個問題。

Thanks. Good afternoon. I want to follow up on next-gen Cologuard. Could you just elaborate on the next steps there? I would like to know the timing when you think this portion of BLUE-C might get published in a journal and when you'll be in a position to submit for the PMA approval? .

謝謝。下午好。我想跟進下一代 Cologuard。您能詳細說明一下接下來的步驟嗎？我想知道您認為 BLUE-C 的這一部分可能在期刊上發表的時間以及您何時可以提交 PMA 批准？ 。

On the first point, we expect to submit to a journal in the near term, focused on next-generation Cologuard. I'm sorry, what was the second question?

關於第一點，我們預計會在短期內提交給一家期刊，重點關注下一代 Cologuard。抱歉，第二個問題是什麼？

Submitting FDA PMA.

提交FDA PMA。

So we expect to have the last module submitted before the end of this year. And then it's probably -- you can think 6 to 9 months for -- or 9 to 12 months, excuse me, for approval.

因此我們預計在今年年底之前提交最後一個模塊。然後可能需要 6 到 9 個月，或者 9 到 12 個月，對不起，才能獲得批准。

We'll take our next question from Matt Sykes with Goldman Sachs.

我們將回答高盛的馬特·賽克斯提出的下一個問題。

Jeff, just maybe talk a little bit about the gross margin expectations for the balance of the year, just given the strong non-GAAP gross margin 75%, how are you thinking about sort of COGS trends through the balance of the year?

Jeff，也許可以談談今年剩餘時間的毛利率預期，考慮到 75% 的強勁非 GAAP 毛利率，您如何看待今年剩餘時間的 COGS 趨勢？

And then secondly, I know it's far off, but I know you've talked in the past about Cologuard 2.0 and sort of the COGS savings for that. Could you just kind of remind us what sort of the magnitude that is versus the current version of Cologuard and how that might impact sort of long-term view on gross margins?

其次，我知道這還很遙遠，但我知道您過去曾談論過 Cologuard 2.0 以及為此節省的銷貨成本。您能否提醒我們，與當前版本的 Cologuard 相比，其規模有多大？這可能會對毛利率的長期看法產生怎樣的影響？

This is Jeff. First on gross margin. Previously, we had guided to about 73% for the year. Obviously, based on the strength in the first half and the outlook for the rest of the year. I think now something in the 73.5% to 74% range is more likely. So feeling good about that. Again, this platform was built to scale. And for those of you who came to Madison back in June, you saw the lab, the quality of the people in that team, the quality of the automation and we expect gross margin improvement for years to come. So feeling good about that.

這是傑夫。首先是毛利率。此前，我們預計今年的增長率約為 73%。顯然，基於上半年的實力和今年剩餘時間的前景。我認為現在 73.5% 到 74% 範圍內的可能性更大。所以感覺很好。同樣，這個平台是按比例構建的。對於那些六月份來到麥迪遜的人來說，你們看到了實驗室、團隊人員的素質、自動化的質量，我們預計未來幾年的毛利率會有所改善。所以感覺很好。

When you think of the second half specifically here, I would just note that in the first half we did have some benefit from that ASP dynamic, I talked about earlier, and also what we'd call our care gap business. And I'll turn it over to Everett for a second to talk about that. The care gap business does carry a slightly lower gross margin. However, it does contribute nicely to EBITDA dollars. And it is an important business for us to be in. So we do expect that business to be a bit bigger in the second half versus the first and weigh a little bit on gross margins all else equal.

當你在這里特別考慮下半年時，我只想指出，在上半年，我們確實從 ASP 動態中受益，我之前談到過，以及我們所說的護理差距業務。我將把它交給埃弗里特一會兒來討論這個問題。護理缺口業務的毛利率確實略低。然而，它確實對 EBITDA 做出了很好的貢獻。這對我們來說是一項重要的業務。因此，我們確實預計下半年的業務規模將比上半年更大，並且在其他條件相同的情況下，對毛利率的影響會更大一些。

Just to your second question on cost of goods for Cologuard 2. There, what we think now is that the cost per test of Cologuard 2 will be at least 5% lower than what it is today for Cologuard 1. It's because of the 10-plus years of work that this team put in to identify more accurate markers and automation and efficiencies that we can build there right into Cologuard 2. So it does help bring down the cost of goods. And importantly here, it helps improve, as Kevin said, it helps reduce that false positive rate by 30%. So it does provide a lot of value for patients. Maybe Everett could talk more about the care gap program, why that's so important to us.

關於 Cologuard 2 的第二個問題。我們現在認為 Cologuard 2 的每次測試成本將比現在的 Cologuard 1 至少低 5%。這是因為 10-再加上該團隊多年來為識別更準確的標記以及自動化和效率而付出的努力，我們可以將其直接構建到Cologuard 2 中。因此，它確實有助於降低商品成本。重要的是，它有助於改善，正如 Kevin 所說，它有助於將誤報率降低 30%。所以它確實為患者提供了很多價值。也許埃弗里特可以更多地談論護理差距計劃，以及為什麼這對我們如此重要。

Yes. Thanks, Jeff. And there's a reason why we're doing the care gap program. First and foremost, we're getting at really hard to screen patients. These are the patients that have been stubborn to get screening. And as I talked about the phenomenon around health systems, payers and health systems are coming to us for help. So it really strengthens our relationships with the payers and the health systems.

是的。謝謝，傑夫。我們開展護理缺口計劃是有原因的。首先也是最重要的是，我們很難篩查患者。這些是頑固地想要接受篩查的患者。當我談到衛生系統周圍的現象時，付款人和衛生系統正在向我們尋求幫助。因此，它確實加強了我們與付款人和衛生系統的關係。

And then lastly, because these patients are stubborn and hard to screen, it's usually in that 50-plus cohort, and that's really helping us lift our share with the 50 plus. And then lastly, our customers are coming back to us saying, we are a better -- much better option than them. They like the 3-year interval. They like our wraparound services and this is a way that we're again improving their screening rates in a very efficient and effective way.

最後，因為這些患者很頑固且難以篩查，所以通常都在 50 歲以上的人群中，這確實有助於我們提高在 50 歲以上患者中的份額。最後，我們的客戶回來告訴我們，我們是比他們更好的選擇。他們喜歡3年的間隔。他們喜歡我們的全方位服務，這是我們再次以非常高效和有效的方式提高他們的篩查率的一種方式。

We'll take our next question from Andrew Brackmann with William Blair.

我們將回答安德魯·布拉克曼和威廉·布萊爾提出的下一個問題。

Jeff, I think you caught out a total of 300 systems who have implemented some form of electronic connections with you guys. How are you sort of thinking about the runway left there for more connections? And can you just sort of talk about the utilization difference that you see amongst that group versus those who have not implemented those connections? .

Jeff，我認為您總共發現了 300 個與你們實現某種形式的電子連接的系統。您如何看待留在那里以提供更多聯繫的跑道？您能否談談您在該組與未實施這些連接的組中看到的利用率差異？ 。

Andrew, this is Jeff. I'll start and then Everett can talk more about some of the commercial initiatives we have to drive that rate higher. When you look at the overall electronic ordering rate for Cologuard, today, it's about 65%, maybe 65% of Cologuard orders come in electronically. Why that's important?

安德魯，這是傑夫。我將開始，然後埃弗雷特可以更多地談論我們必須提高該比率的一些商業舉措。當你看看 Cologuard 的整體電子訂購率時，今天約為 65%，也許 65% 的 Cologuard 訂單是通過電子方式收到的。為什麼這很重要？

When you can make Cologuard easy to order, easy to get the result back to both the physician and the patient. Not only is it a better experience, but also physicians order more. They order over 30% more -- and over time, that's a really strong foundation for us then to layer other tests into. So you can imagine a world where the same electronic foundation supports multiple billion-dollar franchises, whether it's multi-cancer or MRD or Cologuard you name it. Those same pipes that are being placed between our lab and the health systems can be leveraged for other tests. So -- that's a big win for us. There's still ways to go on how far that -- on driving that rate higher. Everett can about talk about how we get there.

當您可以使 Cologuard 易於訂購時，可以輕鬆地將結果返回給醫生和患者。不僅體驗更好，醫生的醫囑也更多。他們的訂單量增加了 30% 以上，隨著時間的推移，這為我們分層進行其他測試奠定了堅實的基礎。因此，您可以想像一個世界，其中同一個電子基金會支持多個價值數十億美元的特許經營權，無論是多種癌症、MRD 還是 Cologuard。我們的實驗室和衛生系統之間放置的相同管道可用於其他測試。所以——這對我們來說是一個巨大的勝利。要想實現這一目標，還有很長的路要走——要提高這一比率。埃弗里特可以談談我們如何實現這一目標。

Yes, absolutely. Again, I go back to data and analytics. And as Kevin and Jeff said at the beginning, we've electronically connected about 40 large health systems so far this year. In the second half, we probably have about another 60 that we're going to connect and it's all about having that data down to the territory level and all of our sales reps having the targets where they need to go to. The last thing I'll say is when I'm out in the field, I often hear physicians say, you have to make it easy for me to write Cologuard, to order Cologuard. And I only have 7 minutes in a health care appointment to really talk to the patient. This is one way that we're making it easier. Our partnering with Epic and the way in which we're getting at our targets will serve as a growth lever moving forward.

是的，一點沒錯。我再次回到數據和分析。正如 Kevin 和 Jeff 一開始所說，今年到目前為止，我們已經通過電子方式連接了大約 40 個大型衛生系統。下半年，我們可能還會連接大約 60 個，這一切都是為了將​​這些數據深入到區域級別，並且我們所有的銷售代表都有他們需要到達的目標。我要說的最後一件事是，當我在外地時，我經常聽到醫生說，你必須讓我輕鬆地寫 Cologuard、訂購 Cologuard。在醫療保健預約中，我只有 7 分鐘時間與患者進行真正的交談。這是我們讓事情變得更容易的一種方法。我們與 Epic 的合作以及我們實現目標的方式將成為前進的增長槓桿。

We'll take our next question from Puneet Souda with Leerink Partners.

我們將接受 Leerink Partners 的 Puneet Souda 提出的下一個問題。

Kevin, Jeff, Everett. I know Everett gets 7 minutes. I get 7 seconds here, so I'll keep it short. Kevin, would love to know if you have early feedback from physicians and providers on the next-gen Cologuard data and what it means for them and updates from the field that you've had so far? And any early feedback on the payer conversations, too?

凱文、傑夫、埃弗里特。我知道埃弗雷特有 7 分鐘的時間。我這裡只有 7 秒，所以我就長話短說吧。 Kevin，很想知道您是否從醫生和提供者那裡得到了關於下一代 Cologuard 數據的早期反饋，以及這對他們意味著什麼以及您迄今為止獲得的該領域的更新？還有關於付款人對話的任何早期反饋嗎？

On Cologuard 2.0?

使用 Cologuard 2.0？

The next-gen Cologuard.

下一代 Cologuard。

So the next-generation Cologuard test, we do have feedback -- we have feedback from KOLs, we have some feedback from payers and people are related. The reduction in the false positive rate, while increasing sensitivity for both cancer and precancer is big. Now that there's a lot of work to do, but the initial feedback, we couldn't be more pleased with. And what does this mean? This means that we believe, number one, that next-generation Cologuard will end up in the -- fits within the current guidelines that already recommend Cologuard on particularly the U.S. PSTF guidelines and the American Cancer Society guidelines. That's important because those guidelines are the most important guidelines that implicate how health systems and payers are measured in terms of their quality measures.

所以在下一代Cologuard測試中，我們確實有反饋——我們有來自KOL的反饋，我們有一些來自付款人和相關人員的反饋。假陽性率顯著降低，同時對癌症和癌前病變的敏感性顯著提高。現在還有很多工作要做，但我們對最初的反饋感到非常滿意。這意味著什麼？這意味著我們相信，第一，下一代 Cologuard 最終將符合當前指南，特別是美國 PSTF 指南和美國癌症協會指南中已經推薦 Cologuard 的指南。這很重要，因為這些指南是最重要的指南，涉及如何根據質量指標來衡量衛生系統和付款人。

So we believe it will be a very smooth transition from Cologuard to next-generation Cologuard. We also see that payers will be receptive to very quickly getting Cologuard adopted and paid for. We'll also be working with the American Medical Association CPT Coding Group to make sure that the coding is smooth. We've been down this road before. We know how to do it. And the team has fired up to make sure that we do this in an efficient and impactful way because patients will benefit from next-generation Cologuard. So all the early signs couldn't be more positive and the team can't wait to bring this to physicians and patients.

因此，我們相信從 Cologuard 到下一代 Cologuard 的過渡將會非常順利。我們還看到付款人會很快接受 Cologuard 的採用和付款。我們還將與美國醫學會 CPT 編碼小組合作，確保編碼順利進行。我們以前也走過這條路。我們知道該怎麼做。該團隊已全力確保我們以高效且有影響力的方式做到這一點，因為患者將從下一代 Cologuard 中受益。因此，所有早期跡像都非常積極，團隊迫不及待地將其帶給醫生和患者。

Our next question comes from Dan Leonard with Credit Suisse.

我們的下一個問題來自瑞士信貸銀行的丹·倫納德。

Switching to Precision Oncology, possibly you could frame how much of the $10 million in revenue upside from your guidance midpoint in the quarter. How much of that was from partnered revenue versus revenue from your own Onco branded products? .

轉向精準腫瘤學，您可能可以確定本季度指導中點相比 1000 萬美元的收入增長有多少。其中有多少來自合作夥伴的收入與來自您自己的 Onco 品牌產品的收入？ 。

And then secondly, can you speak to the second half forecast in Precision Oncology, which I think at the midpoint is a decline from the revenue you reported in the first half?

其次，您能談談精準腫瘤學的下半年預測嗎？我認為中期預測的收入比您上半年報告的收入有所下降？

Dan, this is Jeff. I'll take that one. The broader PO business has really good momentum. When you look at international, for example, international grew 26% in the quarter. So that's even before Japan came online. So feeling good about that. Obviously, that -- there's no partner revenue outside the U.S., even the -- when you look at the global breast franchise grew in the double-digit range. So feeling good about that.

丹，這是傑夫。我會接受那個。更廣泛的 PO 業務發展勢頭確實良好。例如，當你看看國際市場時，國際市場在本季度增長了 26%。這甚至是在日本上線之前。所以感覺很好。顯然，當你看到全球乳房特許經營權以兩位數的速度增長時，美國以外的地區沒有合作夥伴的收入。所以感覺很好。

But we typically don't break out partner revenue and OncoExTra revenue. OncoExTra is off to a good start. It is early. So that's not material yet. However, that product does help broaden out our portfolio and importantly, help getting another product into this really talented sales team's hands that over time will carry not only oncoExTra and Oncotype DX Breast. It also carries MRD and hereditary cancer and other products. So feeling good about the product momentum there.

但我們通常不會細分合作夥伴收入和 OncoExTra 收入。 OncoExTra 有了一個良好的開端。現在還早。所以這還不是實質性的。然而，該產品確實有助於擴大我們的產品組合，重要的是，有助於將另一種產品交到這個真正才華橫溢的銷售團隊手中，隨著時間的推移，該產品將不僅包含oncoExTra 和Oncotype DX Breast。它還攜帶MRD和遺傳性癌症等產品。所以對那裡的產品勢頭感覺很好。

On the seasonality question, the trend I talked about earlier with Cologuard, there's a similar trend with mammography. Fewer women seek out mammograms during the summer, which means a fewer breast cancer diagnoses. Obviously, Oncotype is typically ordered after breast cancer diagnosis. So that trend Q2 to Q3, that's kind of what you'd expect a slowdown in Q2 to Q3 and then a stronger Q4.

關於季節性問題，即我之前與 Cologuard 談到的趨勢，乳房 X 光檢查也有類似的趨勢。在夏季進行乳房X光檢查的女性越來越少，這意味著乳腺癌的診斷數量也會減少。顯然，Oncotype 通常是在乳腺癌診斷後進行的。因此，從第二季度到第三季度的趨勢，您預計第二季度到第三季度會放緩，然後第四季度會更加強勁。

We'll take our next question from Mark Massaro with BTIG.

我們將回答 BTIG 的 Mark Massaro 提出的下一個問題。

Thanks for the question, and great to see everyone in Madison. So thanks for hosting that. I wanted to ask on MRD. I know that you're planning to launch your initial tumor-informed oncodetect MRD test in colorectal cancer, like you guys said in Q4 2023. Can you give me a sense for -- I'm pretty sure that this is your -- the test that you've been developing for some time now.

感謝您的提問，很高興在麥迪遜見到大家。感謝您主持這次會議。我想問一下MRD。我知道你們正計劃在結直腸癌中啟動最初的腫瘤相關OncoDetect MRD 測試，就像你們在2023 年第4 季度所說的那樣。你們能給我一個感覺嗎——我很確定這是你們的— —測試您已經開發了一段時間了。

I'm just curious where the Broad Institute comes in because in that PR, you talked about the MAESTRO program and how this can detect thousands of patient-specific mutations. Obviously, MRD is early. So I'm just curious if you can just give us your sense for your confidence level between your first-gen product and maybe the second-gen product and/or your confidence level on sticking with tumor-informed versus switching over to tumor naive?

我只是好奇布羅德研究所的作用，因為在那篇公關中，您談到了 MAESTRO 計劃以及它如何檢測數千種患者特異性突變。顯然，MRD 還早。所以我很好奇您能否告訴我們您對第一代產品和第二代產品之間的信心水平和/或您對堅持腫瘤知情與切換到腫瘤初始產品的信心水平？

The MAESTRO technology that we exclusively licensed from the Broad Institute will be used in the next generation of MRD. So the test that will be available at the end of this year is the base exact version of the technology. Think of that Broad technology is an extension and enhancement using more mutations, creating greater sensitivity at a similar specificity. And that technology would be used in the studies that we talked about, including the West German Study Group, WGS, and the NSABP, which is the CORRECT II study, so -- the Triad study and the CORRECT II studies, which would use that next-generation version of our MRD test.

我們從布羅德研究所獨家授權的MAESTRO技術將用於下一代MRD。因此，將於今年年底推出的測試是該技術的基本精確版本。認為 Broad 技術是使用更多突變的擴展和增強，在相似的特異性下創造更高的靈敏度。該技術將用於我們討論的研究中，包括西德研究組、WGS 和 NSABP，這是 CORRECT II 研究，因此，Triad 研究和 CORRECT II 研究將使用該技術我們的 MRD 測試的下一代版本。

We'll take our next question from Andrew Cooper with Raymond James.

我們將回答安德魯·庫珀和雷蒙德·詹姆斯提出的下一個問題。

Everybody, thanks for the question and nice quarter for sure. I guess maybe first tagging on to one that I think Andrew -- other Andrew asked, thinking about the health system backlog. Is there a point where these health systems have worked that down and what's their ability to sort of refill that backlog? Is it an ongoing dynamic versus I think you've talked about in the past a little bit of (inaudible) we need to get more folks screened for some of these [rating] dynamics that can make it a little bit seasonal. So just help us think about the runway there. What happens once they've worked that lower? And how the trajectory goes for those that get a little bit more mature once they're onboarded.

大家，謝謝您的提問，當然，這個季度也很美好。我想也許首先會提到一個我認為安德魯——另一個安德魯問的問題，考慮到衛生系統積壓的問題。這些衛生系統是否已經達到了某個程度，他們有什麼能力來補充積壓的工作？這是一個持續的動態嗎？我想你過去已經談到過（聽不清）我們需要讓更多的人對其中一些[評級]動態進行篩選，這可能會使其有點季節性。所以請幫助我們考慮一下那裡的跑道。一旦他們的工作量降低到那麼低，會發生什麼？以及那些一旦入職就變得更加成熟的人的發展軌跡如何。

Yes. I'll touch on that. To me, I -- and if I said backlog, I think when we're talking to health systems, confident, it's a capacity issue. And they just know that they can't do it alone. They have a -- they have a screening population. They have quality metrics that they need to hit. And they know with that screening population, they cannot do it alone with the amount of GI physicians that they have and just their workload, that's why they're coming to us. They're coming to us for help.

是的。我會談到這一點。對我來說，如果我說積壓，我認為當我們自信地與衛生系統交談時，這是一個能力問題。他們只知道他們無法獨自做到這一點。他們有一個——他們有一個篩查人群。他們有需要達到的質量指標。他們知道，對於篩查人群，他們無法單獨依靠他們擁有的胃腸道醫生數量和工作量來完成這項工作，這就是他們來找我們的原因。他們向我們尋求幫助。

They know that Cologuard is a great first-line option. And that's where we're coming in with not just Cologuard, we're coming in with our wraparound services that help them with compliance. We're coming in with marketing tools and efforts that proactively go out to these patients. It's like it surrounds them, it really helps them with getting their patients screened and also hitting their quality metrics, which benefits that health system tremendously.

他們知道 Cologuard 是一個很好的一線選擇。這就是我們不僅提供 Cologuard，還提供幫助他們遵守法規的全方位服務。我們正在帶著營銷工具和努力主動向這些患者推廣。就像它圍繞著他們一樣，它確實幫助他們對患者進行篩查並達到他們的質量指標，這對衛生系統非常有利。

Just to add on to that, the long wait times for colonoscopy has become a nationwide issue. And that's driven by part one is that 18 months ago, a little more than that now, the USPSTF guideline group lowered the screening age to age 45. As you know, that added 15 million to 20 million Americans into the screening population, all starting to need to be screened at once and that permanently increased the number of people who needed to be screened while that capacity, as Everett mentioned, is fixed.

除此之外，結腸鏡檢查等待時間過長已成為全國性問題。第一部分推動的因素是，18 個月前，比現在稍多一點，USPSTF 指南小組將篩查年齡降低至45 歲。如您所知，這增加了1500 萬至2000 萬美國人的篩查人群，所有這些都從需要立即進行篩查，並且永久增加了需要篩查的人數，而正如埃弗里特提到的那樣，容量是固定的。

The other part of it is that capacity just isn't growing. In fact, in some markets it's shrinking because we're not seeing -- we're seeing retirements outpace the number of new physicians that are becoming GIs and entering the markets. And so there is that dynamic that Cologuard is just going to help address the sheer number of people that need to be screened for decades to come, we believe.

另一方面是容量沒有增長。事實上，在一些市場，它正在萎縮，因為我們沒有看到——我們看到退休的人數超過了成為美國士兵並進入市場的新醫生的數量。因此，我們相信，Cologuard 將幫助解決未來幾十年需要篩查的大量人群的問題。

We'll take our next question from Kyle Mikson with Canaccord Genuity.

我們將接受 Canaccord Genuity 的凱爾·米克森 (Kyle Mikson) 提出的下一個問題。

I want to go back to the financials and the model really, Jeff, can you kind of walk through market implications of this $50 million COVID headwind to rescreen revenue in the second half? I guess like for context, you're guiding to a mid-single-digit adjusted EBITDA margin in the second half. That makes sense given the rescreening revenue is higher margin when that headwind lifts in the first half of next year, you would think that margins would bounce back. But that's kind of in line with how you talk about pushing margins higher over time. But you have other studies coming up in '24 and beyond. So I guess just wrapping this up, how do we kind of think about the margin profile going forward in the context of all these different pieces?

我真的想回到財務和模型上來，傑夫，你能否介紹一下這場 5000 萬美元的新冠逆風對市場的影響，以重新篩選下半年的收入？我想就上下文而言，下半年調整後的 EBITDA 利潤率將達到中個位數。這是有道理的，因為明年上半年逆風解除時，重審收入的利潤率會更高，你會認為利潤率會反彈。但這與您所說的隨著時間的推移提高利潤率的說法是一致的。但 24 年及以後還會有其他研究。所以我想總結一下，我們如何考慮在所有這些不同部分的背景下未來的利潤狀況？

Yes. Thanks for the question. Well, just about a month ago, we gave long-term margin guidance of at least 20% in 2027. That's adjusted EBITDA margins. We feel very good about our ability to get there based on the momentum we have today. But look, we've got work to do. There's huge markets out there. You talked about COVID rescreen the headwind there. Again, it's over $50 million this year. a big part of that is in Q3.

是的。謝謝你的提問。嗯，就在大約一個月前，我們給出了 2027 年至少 20% 的長期利潤指引。這是調整後的 EBITDA 利潤率。基於我們今天的勢頭，我們對實現這一目標的能力感到非常滿意。但是看，我們還有工作要做。那裡有巨大的市場。你談到了新冠疫情重新篩選那裡的逆風。今年再次超過 5000 萬美元。其中很大一部分是在第三季度。

Yes, I think it's important to look at the guidance for Q3. What we're guiding to is still for screening, 30% growth and over $100 million of incremental revenue, that's almost exactly what it was in Q2. So there's very strong growth here, and we're going to make sure we make the right investments in this business to keep scaling. So I feel good about it. I do -- as we scale, we'll talk more about next year on a future call. But as we scale, I do expect margins and cash flow to improve for years to come.

是的，我認為查看第三季度的指導很重要。我們的指導仍然是篩選，30% 的增長和超過 1 億美元的增量收入，這幾乎與第二季度完全相同。因此，這裡的增長非常強勁，我們將確保對該業務進行正確的投資以保持規模擴大。所以我對此感覺很好。我確實如此——隨著我們規模的擴大，我們將在未來的電話會議上更多地討論明年的情況。但隨著我們規模的擴大，我確實預計未來幾年的利潤率和現金流將會改善。

We'll take our next question from Liza Garcia with UBS.

我們將回答瑞銀集團麗莎·加西亞 (Liza Garcia) 提出的下一個問題。

I guess just thinking. And I know kind of as we're moving internationally into Japan, it's a little bit different because it's oncotype and is the first mover. But you've spent so many years kind of honing the operational model with cologuard and you've obviously had a lot of learnings. But kind of as you're thinking about internationally and kind of the best way to tackle, kind of what have your learnings been to kind of -- just given kind of obviously, the revisions that you've done and the operational leverage you've been like how you're thinking about tackling internationally to be as effective as possible and kind of the margin profile to kind of get -- I guess, kind of what learnings you think you can leverage from your U.S. experience into the international market kind of where I'm getting here.

我想只是想想而已我知道，當我們在國際上進入日本時，它有點不同，因為它是 oncotype 並且是先行者。但您花了這麼多年的時間來磨練 cologuard 的運營模型，顯然您已經學到了很多東西。但是，當你思考國際問題以及解決問題的最佳方法時，你所學到的東西是什麼——很明顯，你所做的修改以及你的運營槓桿作用”就像你如何考慮如何在國際上盡可能有效地應對，以及如何獲得某種利潤狀況——我想，你認為你可以從美國的經驗中學到什麼來進入國際市場我要去哪裡。

We have focused relentlessly on Cologuard in the U.S. And as a result of that, we have developed great scale, reach and a ton of learnings. Applying that outside the U.S., we haven't provided guidance as to when Cologuard would be brought outside the U.S. There's clearly a need though. Just if you take a look at the EU market, it is a significant opportunity because the colon cancer mortality rate is significantly higher in Europe than it is in the U.S. Screening -- maybe 30% of the population is up-to-date with colorectal cancer screen. So there's an opportunity there. We'll wait until at some point in the future to talk about what our plans are outside the U.S., certainly the learnings that we have developed in the U.S. and the focus that we've had will help as we export Cologuard outside the U.S.

我們不懈地關注美國的 Cologuard，因此，我們已經發展了巨大的規模、覆蓋範圍和大量的經驗教訓。在美國境外應用這一點時，我們尚未提供有關何時將 Cologuard 引入美國境外的指導。不過，顯然有必要。如果你看看歐盟市場，就會發現這是一個重要的機會，因為歐洲的結腸癌死亡率明顯高於美國。篩查——也許 30% 的人口接受了最新的結直腸癌篩查癌症篩查。所以那裡有一個機會。我們將等到將來的某個時候談論我們在美國以外的計劃，當然，我們在美國學到的知識以及我們所關注的重點將有助於我們將 Cologuard 出口到美國以外的地區。

And Liza, this is Jeff. Just to add to Kevin's answer here. That international foundation is strong today to put some perspective around it. We have a team of over 200 people in our international team, really top managed team here. We do business in over 100 countries already. This has taken us years in fact, probably over a decade to build up this global footprint. And what that's getting us is strong double-digit growth for years to come.

麗莎，這是傑夫。只是為了補充凱文的答案。今天，這個國際基礎非常強大，可以圍繞它提出一些觀點。我們的國際團隊擁有 200 多人，是真正的頂級管理團隊。我們已經在 100 多個國家開展業務。事實上，我們花了數年，甚至可能十多年的時間才建立起這一全球足跡。這給我們帶來的是未來幾年強勁的兩位數增長。

The base of revenue today is already over $150 million. with good margins. It is a nicely profitable business, largely on 1 product, and as Kevin talked about, adding more and more products to that will help improve the profitability. And this is one of the core reasons why back in 2019 that we sought out to really come together with Genomic Health is this high-quality international footprint. This sets us up for years to come to provide really a strong important leg of growth and importantly, to help patients around the world.

如今的收入基礎已經超過 1.5 億美元。具有良好的利潤率。這是一項利潤豐厚的業務，主要依靠一種產品，正如凱文所說，添加越來越多的產品將有助於提高盈利能力。這就是我們在 2019 年尋求與 Genomic Health 真正合作的核心原因之一，就是這種高質量的國際足跡。這使我們能夠在未來幾年提供真正強大的重要增長支柱，更重要的是，幫助世界各地的患者。

We'll take our next question from Alex Nowak with Craig-Hallum Capital.

我們將回答 Craig-Hallum Capital 的 Alex Nowak 提出的下一個問題。

I was wondering what is the latest time lines for Cologuard blood. And this is a question I've had since the Analyst Day. It seems that Cologuard 2.0 data was so good why pursue a different assay in blood altogether for colon cancer screening. Everett mentioned docs only have a few minutes with their patients. So does adding the test, does it potentially risk making the conversations a bit confusing for primary care in particular?

我想知道 Cologuard 血液的最新時間表是什麼。這是我自分析師日以來一直在想的一個問題。看來 Cologuard 2.0 的數據非常好，為什麼要在血液中採用不同的檢測方法來進行結腸癌篩查呢？埃弗里特提到，醫生與患者的交流時間只有幾分鐘。那麼，添加測試是否有可能使對話變得有點混亂，特別是對於初級保健來說？

So Cologuard blood will be -- or what we call our CRC blood test, it has been named yet. We expect middle of next year to have data. What is the role for a blood test. The role for a blood test, we believe, will be for patients who refuse a frontline recommended screening test per USPSTF guidelines. And there are people who refuse other -- all forms of colon cancer screening.

因此，Cologuard 血液測試將是——或者我們所說的 CRC 血液測試，它已經被命名了。我們預計明年年中會有數據。驗血有什麼作用。我們認為，血液檢測的作用將針對那些拒絕按照 USPSTF 指南推薦的一線篩查檢測的患者。有些人拒絕其他所有形式的結腸癌篩查。

And for those patients are a blood tests, which is clearly not going to be as good as detecting precancerous polyps or stage 1 cancers as other frontline screening tests, there's still a role for that, and it's important to screen those individuals. We happen to know who those patients are. People have chosen Cologuard over colonoscopy and yet haven't returned to test.

對於這些患者來說，血液測試顯然不如其他一線篩查測試那樣檢測癌前息肉或一期癌症，但它仍然有作用，而且對這些人進行篩查很重要。我們碰巧知道那些病人是誰。人們選擇了 Cologuard 而不是結腸鏡檢查，但尚未返回測試。

So it's a discrete relatively small population on a percentage basis, but large in terms of the sheer number of people in the U.S. measuring in the millions. So we'll be able to engage with those patients, if they have not completed a Cologuard test, not completed a colonoscopy, work with their health care provider that we have a deep relationship with. Work with the health system to do our best to get those patients screened. And so that's -- our mission is to eradicate colon cancer, and that's going to -- this is going to be an important tool that we have to help achieve that mission.

因此，從百分比來看，這是一個相對較小的離散人口，但就美國數百萬人口而言，這個數字很大。因此，如果這些患者尚未完成 Cologuard 測試、未完成結腸鏡檢查，我們將能夠與他們接觸，並與我們有深厚關係的醫療保健提供者合作。與衛生系統合作，盡最大努力對這些患者進行篩查。因此，我們的使命是根除結腸癌，這將成為我們幫助實現這一使命的重要工具。

Thank you. And that does conclude today's question-and-answer session as well as presentation. Thank you for your participation today, and you may now disconnect.

謝謝。今天的問答環節和演示就到此結束。感謝您今天的參與，您現在可以斷開連接。