Exact Sciences Corp (EXAS) 2023 Q3 法說會逐字稿

Good afternoon, ladies and gentlemen, and welcome to the Exact Sciences Third Quarter 2023 Earnings Conference Call. (Operator Instructions) Please be advised that this call is being recorded. (Operator Instructions)

女士們、先生們，下午好，歡迎參加 Exact Sciences 2023 年第三季財報電話會議。 （操作員說明）請注意，此通話正在錄音。 （操作員說明）

And now at this time, I would like to turn the call over to Mr. Erik Holznecht, Manager of Investor Relations. Please go ahead, sir.

現在這個時候，我想將電話轉給投資者關係經理 Erik Holznecht 先生。請繼續，先生。

Thanks, Bo. Thank you for joining us for Exact Sciences' Third 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.

謝謝，博。感謝您參加 Exact Sciences 2023 年第三季電話會議。今天參加電話會議的是該公司董事長兼執行長凱文康羅伊 (Kevin Conroy)；和我們的財務長 Jeff Elliott。我們的首席商務長 Everett Cunningham 也將回答問題。

Exact Sciences issued a news release earlier this afternoon detailing our Third Quarter financial results. This news release and today's presentation are available on our website at exactsciences.com.

Exact Sciences 今天下午早些時候發布了一份新聞稿，詳細介紹了我們第三季的財務表現。本新聞稿和今天的演示可在我們的網站 exactsciences.com 上取得。

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.

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有重大差異。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。兩者都可以透過我們的網站存取。

I'll now turn the call over to Kevin.

我現在將電話轉給凱文。

Thank you, Erik. Our Third Quarter results reflect our commitment to help eradicate cancer with tests that prevent it, detect it earlier, and guide its treatment. Cologuard and Oncotype DX fuel are growing $2.5 billion business and the next wave of breakthrough cancer diagnostic innovations. Our focus on solving the needs of patients and health care providers powered outstanding third quarter results, allowing us to raise our 2023 guidance for both revenue and adjusted EBITDA.

謝謝你，埃里克。我們第三季的業績反映了我們致力於透過預防癌症、及早發現癌症並指導治療的測試來幫助根除癌症。 Cologuard 和 Oncotype DX Fuel 的業務正在成長 25 億美元，並且正在推動下一波突破性癌症診斷創新。我們專注於解決患者和醫療保健提供者的需求，這推動了第三季度的出色業績，使我們能夠提高 2023 年收入和調整後 EBITDA 的指導。

Highlights from the third quarter include delivering more than 1 million total tests, including a record number of Cologuard and Oncotype DX results, growing core revenue of 23% to $625 million, also a record; generating $56 million of adjusted EBITDA, a $69 million improvement; exceeding 1 million people screened with Cologuard between ages 45 and 49 in the 2.5 years since the recommended start age was moved from 50 to 45; expanding the impact of Oncotype DX by launching in Japan on a reimbursed basis; beginning to integrate Resolution Biosciences and our new liquid therapy selection test into our portfolio; presenting pivotal BLUE-C study results at the American College of Gastroenterology Conference, demonstrating next-generation Cologuard met all endpoints; and showcasing the breadth and depth of our research with 5 abstracts with our Precision Oncology and multi-cancer test at the European Society of Medical Oncology Congress.

第三季的亮點包括交付超過 100 萬次總測試，其中包括創紀錄數量的 Cologuard 和 Oncotype DX 結果，核心收入增長 23% 至 6.25 億美元，同樣創紀錄；產生 5,600 萬美元的調整後 EBITDA，增加 6,900 萬美元；自從建議開始年齡從 50 歲移至 45 歲以來，在 2.5 年內，超過 100 萬人在 45 歲至 49 歲之間接受了 Cologuard 篩檢；透過在日本以報銷方式推出，擴大 Oncotype DX 的影響力；開始將Resolution Biosciences 和我們新的液體療法選擇測試整合到我們的產品組合中；在美國胃腸病學會會議上展示關鍵的 BLUE-C 研究結果，證明下一代 Cologuard 達到了所有終點；並在歐洲腫瘤內科學會大會上透過我們的精準腫瘤學和多癌症測試的 5 篇摘要展示我們研究的廣度和深度。

The investments we've made in our core business are returning sustainable revenue growth and margin expansion. This allows us to strengthen our world-class team and develop new life-changing solutions for patients.

我們對核心業務的投資正在帶來可持續的收入成長和利潤率擴張。這使我們能夠加強我們的世界一流團隊，並為患者開發改變生活的新解決方案。

Jeff will now review our third quarter results.

傑夫現在將回顧我們第三季的業績。

Thanks Kevin. Third Quarter revenue of $628 million grew 20% or 23% on a core basis, excluding COVID testing, M&A and FX. Screening revenue of $472 million increased 31%, driven by broad-based momentum in Cologuard adoption. This momentum was fueled by commercial productivity and our deep relationships with payers and providers. More than 10,000 new health care professionals ordered Cologuard during the quarter, more than 331,000 have ordered since launch. As we said last quarter, about 75% of primary care physicians have ordered Cologuard. So we don't plan to provide the number of new physicians starting next year.

謝謝凱文。第三季營收為 6.28 億美元，核心營收成長 20% 或 23%，不包括新冠病毒檢測、併購和外匯。由於 Cologuard 廣泛採用的勢頭，放映收入增長了 31%，達到 4.72 億美元。這一勢頭是由商業生產力以及我們與付款人和提供者的深厚關係所推動的。本季度有超過 10,000 名新醫療保健專業人員訂購了 Cologuard，自推出以來已訂購人數超過 331,000 人。正如我們上季度所說，大約 75% 的初級保健醫生訂購了 Cologuard。因此，我們不打算從明年開始提供新醫生的數量。

Precision and Oncology revenue grew 3% to $156 million or 5% on a core basis. Growth was led by Oncotype DX, which expanded 14% globally. Third quarter GAAP gross margin was 70%. Non-GAAP gross margin, excluding amortization of acquired intangibles, was 73%. GAAP net income was $1 million, including a gain of $72 million related to the prostate business sale. Adjusted EBITDA was $56 million, an improvement of $69 million, driven by better-than-expected revenue and continued operating expense discipline. Cash provided by operating activities was $24 million. Free cash flow was a loss of less than $1 million, an improvement of $85 million.

精準和腫瘤學收入成長 3%，達到 1.56 億美元，核心收入成長 5%。 Oncotype DX 引領成長，全球擴張 14%。第三季 GAAP 毛利率為 70%。非公認會計準則毛利率（不包括收購的無形資產攤銷）為 73%。 GAAP 淨利潤為 100 萬美元，其中包括與攝護腺業務出售相關的 7,200 萬美元收益。調整後 EBITDA 為 5,600 萬美元，由於收入優於預期和持續嚴格的營運費用控制，增加了 6,900 萬美元。經營活動提供的現金為2400萬美元。自由現金流損失不到 100 萬美元，增加了 8,500 萬美元。

Third quarter included a onetime payment of $33 million for a previously disclosed and reserved matter. We ended the quarter with cash and securities of $734 million.

第三季包括為先前揭露和保留的事項一次性支付 3,300 萬美元。本季結束時，我們擁有 7.34 億美元的現金和證券。

Turning to guidance. We're raising total revenue to between $2.476 billion and $2.486 billion for the year. This assumes Screening revenue between $1.848 billion and $1.853 billion, Precision Oncology revenue between $622 million and $627 million and COVID revenue of $6 million. We discontinued COVID testing in July.

轉向指導。我們將把今年的總收入提高到 24.76 億美元至 24.86 億美元之間。假設篩檢收入在 18.48 億美元至 18.53 億美元之間，精準腫瘤學收入在 6.22 億美元至 6.27 億美元之間，COVID 收入為 600 萬美元。我們在 7 月停止了新冠病毒檢測。

For the year, (inaudible) 23% core revenue growth with 30% growth in Screening and 7% core growth in Precision Oncology. We're raising adjusted EBITDA guidance to between $195 million and $205 million. This implies an adjusted EBITDA margin of 8%, giving us confidence in reaching at least 20% by 2027. The Exact Sciences platform was built to drive sustainable double-digit revenue growth and steady margin improvement. The progress we've made this year puts us in a great position to reach our long-term financial targets.

今年（聽不清楚）核心收入成長 23%，其中篩檢業務成長 30%，精準腫瘤學核心收入成長 7%。我們將調整後 EBITDA 指引值提高至 1.95 億美元至 2.05 億美元之間。這意味著調整後的 EBITDA 利潤率為 8%，讓我們有信心到 2027 年達到至少 20%。Exact Sciences 平台的建立是為了推動可持續的兩位數收入成長和穩定的利潤率提高。我們今年的進展使我們處於實現長期財務目標的有利位置。

Back to you, Kevin.

回到你身上，凱文。

Thanks, Jeff. We've delivered our 13 millionth Cologuard test results during the third quarter. Based on known prevalence data, we estimate Cologuard has helped find precancerous polyps and early-stage cancer in nearly 0.5 million people over the past 10 years. Cologuard is becoming deeply ingrained in clinical practice. For example, last quarter, 169,000 health care providers ordered Cologuard, a new record. Those providers are ordering Cologuard more frequently than last year. We received nearly 70% of Cologuard orders electronically, and Cologuard brand awareness with consumers reached 87%, an all-time high. There are 60 million Americans aged 45 to 85 not up to date with colon cancer screening. Cologuard is the ideal solution to get people screened accurately and conveniently. Cologuard is included in all major guidelines, quality measures and nearly universally covered by commercial insurance with no cost to the patient.

謝謝，傑夫。我們在第三季交付了第 1300 萬份 Cologuard 測試結果。根據已知的盛行率數據，我們估計 Cologuard 在過去 10 年中已幫助近 50 萬人發現了癌前息肉和早期癌症。 Cologuard 正在臨床實踐中根深蒂固。例如，上個季度，169,000 名醫療保健提供者訂購了 Cologuard，創下了新紀錄。這些供應商訂購 Cologuard 的頻率比去年更高。我們收到近 70% 的 Cologuard 電子訂單，Cologuard 品牌在消費者中的認知度達到 87%，創歷史新高。有 6 千萬 45 歲至 85 歲的美國人沒有接受最新的大腸癌篩檢。 Cologuard 是準確、便利地進行人員篩檢的理想解決方案。 Cologuard 包含在所有主要指南、品質措施中，幾乎普遍由商業保險承保，患者無需支付任何費用。

We've demonstrated Cologuard can scale rapidly. Capacity for screening colonoscopies is relatively fixed at about 6 million procedures per year. Our sales and marketing teams are creating urgency around the importance of screening by, one, partnering with health systems and payers to address their screening rates and related quality measures; two, educating providers about the benefits of Cologuard through more than 1 million face-to-face engagements each year; and three, using a multichannel marketing approach to elevate colon cancer screening. These efforts are increasingly making Cologuard a first-line screening choice.

我們已經證明 Cologuard 可以快速擴展。大腸鏡檢查的篩檢能力相對固定為每年約 600 萬例手術。我們的銷售和行銷團隊正在圍繞篩檢的重要性創造緊迫感，一是與衛生系統和付款人合作，解決他們的篩選率和相關品質措施；第二，每年透過超過 100 萬次面對面交流，向提供者宣傳 Cologuard 的優勢；第三，利用多通路行銷方式提升大腸癌篩檢水準。這些努力使 Cologuard 逐漸成為第一線篩檢選擇。

Oncotype DX is internationally recognized as standard of care and it anchors our Precision Oncology portfolio. Oncotype DX helps early-stage breast cancer patients to determine whether they will benefit from chemotherapy and assesses their likelihood of recurrence. We're using its global presence to enter new markets and accelerate the availability of future advanced cancer tests all around the world. For example, we launched Oncotype DX in Japan 2 months ago. Japan will soon become our largest market outside the U.S.

Oncotype DX 是國際公認的護理標準，它是我們精準腫瘤學產品組合的基礎。 Oncotype DX 幫助早期乳癌患者確定他們是否會從化療中受益並評估其復發的可能性。我們正在利用其全球影響力進入新市場，並加快未來先進癌症測試在全球的可用性。例如，我們兩個月前在日本推出了Oncotype DX。日本很快就會成為我們在美國以外最大的市場

Breast cancer is the most common cancer among Japanese women with about 45,000 new diagnosis of early-stage HR-positive HER2-negative breast cancer each year. To provide a more comprehensive understanding of each patient's disease, we're planning to introduce new genomic tools, including OncoDetect, our molecular residual disease test and our recently acquired blood-based therapy selection test that complements our tissue-based OncoExTra offer.

乳癌是日本女性最常見的癌症，每年約有 45,000 例新診斷出早期 HR 陽性 HER2 陰性乳癌。為了更全面地了解每位患者的疾病，我們計劃推出新的基因組工具，包括OncoDetect、我們的分子殘留疾病測試和我們最近獲得的基於血液的治療選擇測試，該測試補充了我們基於組織的OncoExTra 產品。

Expanding our portfolio allows our oncology customers to work with one trusted advanced diagnostics partner. Combining information from our tests will help guide each of their patients to the most effective cancer treatments. The Exact Sciences team has made progress in our three most impactful pipeline programs, colon cancer screening, molecular residual disease and multi-cancer screening. For next-generation Cologuard, our data presentation at ACG in October have demonstrated the pivotal head-to-head BLUE-C studies is the new gold standard for evidence in colon cancer screening.

擴大我們的產品組合使我們的腫瘤學客戶能夠與值得信賴的高級診斷合作夥伴合作。結合我們測試的資訊將有助於指導每位患者接受最有效的癌症治療。 Exact Sciences 團隊在我們三個最具影響力的管道項目（結腸癌篩檢、分子殘留疾病和多癌篩檢）方面取得了進展。對於下一代 Cologuard，我們 10 月在 ACG 上展示的數據表明，關鍵的頭對頭 BLUE-C 研究是結腸癌篩檢證據的新黃金標準。

The study was designed to validate our prespecified algorithm. BLUE-C enrolled over 20,000 people, including 98 with cancer and more than 2,000 with pre-cancerous polyps. This provided excellent statistical power for analyzing our predefined primary and secondary.

該研究旨在驗證我們預先指定的演算法。 BLUE-C 招募了超過 20,000 人，其中 98 人患有癌症，2,000 多人患有癌前息肉。這為分析我們預先定義的主要和次要提供了出色的統計能力。

Next-generation Cologuard met all endpoints achieving 94% cancer sensitivity, 93% sensitivity for curable stage cancer or stages 1 to 3 and 91% specificity as calculated by FDA. Specificity, excluding small adenomas and patients with no findings was 93%. The results also confirm next-generation Cologuard is superior to the FIT test in detecting cancer and precancerous polyps. Our team plans to finalize the FDA submission in December, and we're working to make next-generation Cologuard available to patients in early 2025.

下一代 Cologuard 滿足了所有終點，根據 FDA 的計算，癌症敏感性為 94%，可治癒階段癌症或 1 至 3 期癌症敏感性為 93%，特異性為 91%。排除小腺瘤和無發現的患者後，特異性為 93%。結果也證實，下一代 Cologuard 在檢測癌症和癌前息肉方面優於 FIT 測試。我們的團隊計劃於 12 月完成向 FDA 提交的申請，我們正在努力在 2025 年初向患者提供下一代 Cologuard。

In molecular residual disease, we're on track to make our tumor-informed test available for colon cancer patients by year-end and for breast cancer patients next year. At Exact Sciences, we will help eradicate cancer by preventing it, detecting it earlier and guiding its treatment. We have an innovative, patient-focused culture; a deep scientific understanding of cancer; and the best portfolio in advanced diagnostics. The strength of our business allows us to invest in solving the most pressing challenges our customers face, while delivering sustainable double-digit revenue growth and expanding profit margins. We are in a leading position to help achieve our important mission.

在分子殘留疾病方面，我們預計在年底前為結腸癌患者提供腫瘤資訊檢測，並在明年為乳癌患者提供腫瘤資訊檢測。在 Exact Sciences，我們將透過預防、早期檢測和指導治療來幫助根除癌症。我們擁有創新、以病人為中心的文化；對癌症有深刻的科學認知；以及先進診斷領域的最佳產品組合。我們的業務實力使我們能夠投資解決客戶面臨的最緊迫的挑戰，同時實現可持續的兩位數收入成長和不斷擴大的利潤率。我們處於領先地位，有助於實現我們的重要使命。

Before we take your questions, I'd like to congratulate Megan Jones on her new role as VP of Finance International. Through her 6.5-year tenure leading our IR team, Megan has proven herself as a strategic thought leader and an outstanding business partner. We have big plans for her going forward.

在回答您的問題之前，我謹祝賀梅根瓊斯 (Megan Jones) 擔任國際金融副總裁。在領導我們的 IR 團隊的 6.5 年任期中，Megan 已經證明了自己是一位策略思想領袖和傑出的業務合作夥伴。我們對她的未來有宏偉的計劃。

We're now happy to take your questions.

我們現在很樂意回答您的問題。

(Operator Instructions) We'll go first this afternoon to Catherine Schulte at Baird.

（操作員說明）今天下午我們先去貝爾德的凱瑟琳舒爾特。

Kevin, I just wanted to kick things off with a big picture question on Cologuard. Just given where you sit today around 10% market share, how do you think Cologuard is positioned for the long term? And can you just help us think about the strategy to get from where we are today to your 50% long-term market share target?

Kevin，我只是想從一個關於 Cologuard 的大局問題來開始。鑑於您目前的市佔率約為 10%，您認為 Cologuard 的長期定位如何？您能否幫助我們考慮從目前的狀況到您 50% 的長期市佔率目標的策略？

Thanks, Catherine. We're so excited about the impact that Cologuard can have over the long term. And as you know, it's been a long road to start to change the standard of care in screening. You're talking about a population of over 100 million Americans that need to be screened and 60 million who are not up to date today. So if you take a look at this over the next decade, you have to look at who has the best team. We believe we have the best team. We have the best test presently and our next-generation Cologuard test and the best clinical evidence as BLUE-C data is sterling and such a strong case for moving, screening generally to noninvasive at-home testing.

謝謝，凱瑟琳。我們對 Cologuard 的長期影響感到非常興奮。如您所知，開始改變篩檢護理標準還有很長的路要走。您談論的是超過 1 億美國人需要接受篩檢，目前還有 6,000 萬美國人沒有及時接受篩檢。因此，如果你審視未來十年的情況，你必須看看誰擁有最好的團隊。我們相信我們擁有最好的團隊。我們擁有目前最好的測試和下一代 Cologuard 測試以及最好的臨床證據，因為 BLUE-C 數據非常可靠，並且是將篩檢普遍轉移到非侵入性家庭測試的有力理由。

And then you couple this with the incredible services and IT infrastructure and commercial organization that we have. We believe that we can go get a large percentage of those 60 million people screened. And we also believe we can leverage this then outside the U.S. over the next decade and reach well over a 100 million people outside the U.S. So we're excited about the other programs we have in colon cancer screening and the ability to surround our customer, patients and physicians and health systems, large organized health systems to get more people screened. So over the next decade, where we see growth continuing for as far as we can see with all of these strengths.

然後將其與我們擁有的令人難以置信的服務、IT 基礎設施和商業組織結合。我們相信我們可以對這 6000 萬人中的很大一部分進行篩檢。我們也相信，未來十年我們可以在美國以外的地區利用這一點，覆蓋美國以外的超過1 億人。因此，我們對我們在結腸癌篩檢方面的其他計劃以及圍繞我們的客戶的能力感到興奮，病人、醫生和衛生系統，大型有組織的衛生系統，讓更多的人接受篩檢。因此，在接下來的十年中，我們預計在所有這些優勢的幫助下，成長將持續下去。

We go next now to Brandon Couillard at Jefferies.

接下來我們請聽聽傑富瑞 (Jefferies) 的布蘭登‧庫亞爾 (Brandon Couillard)。

Jeff or Kevin, I'm just curious how you're thinking about the fourth quarter, which usually is tricky in terms of seasonality. Do you think this year will be any different in terms of seasonality? Just thinking about Cologuard being so much more ingrained, it's so much deeper penetrated in health systems. Just curious if you anticipate a big bolus of gap testing. How we think about, I guess, fourth quarter dynamics?

傑夫或凱文，我只是好奇你如何看待第四季度，就季節性而言，第四季通常很棘手。您認為今年的季節性會有什麼不同嗎？想想 Cologuard 如此根深蒂固，它在衛生系統中的滲透如此深入。只是好奇您是否預計會進行大量間隙測試。我想我們如何看待第四季的動態？

Brandon, this is Jeff. I'll start and then maybe Everett can jump in. Look, we're really pleased with the results through three quarters. The team has delivered, I think, outstanding results. We've made very good progress towards our long-term 2027 financial goals. If you just look at what we've done so far, what we're -- the new guide, the updated guide calls for is over $420 million of incremental growth this year, which is the best so far. It's a really good year. So we feel good about that.

布蘭登，這是傑夫。我先開始，然後埃弗雷特也許可以加入。看，我們對三個季度的結果非常滿意。我認為該團隊取得了出色的成果。我們在實現 2027 年長期財務目標方面取得了巨大進展。如果你看看我們迄今為止所做的事情，我們的新指南、更新後的指南要求今年的增量增長超過 4.2 億美元，這是迄今為止最好的。這真是美好的一年。所以我們對此感覺良好。

When you look at your comments on 3Q, 4Q that trends, just take a step back here. Look, I don't expect any difference here because the main reason -- the reason for the seasonal effect is not really ours, it really relates to the holidays. When you think of Thanksgiving, Christmas and New Year, fewer people go out and get physicals.

當你看到你對第三季、第四季趨勢的評論時，請退後一步。看，我預計這裡不會有任何差異，因為主要原因 - 季節性影響的原因並不是我們真正的原因，它確實與假期有關。當你想到感恩節、聖誕節和新年時，外出體檢的人就會減少。

They're spending time at home with their families and friends, which they should be as opposed to going out and seeking preventative care. So that leads to fewer physicals and fewer Cologuard orders temporarily during the holidays. Patients are also slower to return the kits that are out in the field during that time. So again, temporarily Q4 feels a bit of that and then Q1 feels a bigger impact from the holidays. So I don't expect that to change this year. That trend is always going to be there. Again, it's not specific to us. It's more primary care and general.

他們應該在家中與家人和朋友共度時光，而不是出去尋求預防性護理。因此，這會導致假期期間暫時減少實物採購和 Cologuard 訂單。在此期間，患者歸還現場的試劑盒的速度也較慢。所以，第四季暫時會受到一些影響，然後第一季會受到假期的更大影響。所以我預計今年這種情況不會改變。這種趨勢永遠存在。再說一遍，這不是我們特有的。它更多的是初級保健和一般護理。

You mentioned the care gap business. It's a smaller part of the business. I do expect that to be a little weighted towards Q4, but whatever and team are doing are looking to build that up as a bigger part of the business as we scale. I did notice this year that some of the business we had previously expected to come in Q4 actually fell into Q3. So that explains part of the dynamic on 3Q to 4Q this year.

您提到了護理差距業務。這是業務的一小部分。我確實預計第四季度的比重會有所增加，但無論我們團隊正在做什麼，都希望隨著我們的規模擴大，將其作為業務的更大組成部分。今年我確實注意到，我們之前預計第四季度出現的一些業務實際上落到了第三季。這解釋了今年第三季至第四季的部分動態。

We go next now to Derik De Bruin of Bank of America.

接下來我們請美國銀行的德里克‧德布魯因 (Derik De Bruin) 發言。

So I got a couple. So on Cologuard 2.0, really good data. How should we think about pricing and reimbursement versus Cologuard classic, I guess? Is it going to be a price benefit to that? And on rescreening, what was the tailwind from rescreens in '23? And how do you think about the opportunity for rescreening in '24?

所以我得到了一對。所以在 Cologuard 2.0 上，數據非常好。我想，與 Cologuard classic 相比，我們應該如何考慮定價和報銷？這會帶來價格優勢嗎？關於重映，23 年重映的推手是什麼？您如何看待24年重新篩選的機會？

I'll take the first part of that and add -- toss the rescreening over to Jeff and Everett. What's the first part -- yes. In terms of pricing, we are -- we're not prepared to talk about price at a detailed level. Taking a step up, Cologuard 2.0 or next-generation Cologuard is -- provides a significant increment in value because there are 30% fewer false positives. False positives lead to unnecessary colonoscopies, lead to unnecessary complications, et cetera, leading to cost and diminished care.

我將採取第一部分並添加 - 將重新篩選交給傑夫和埃弗雷特。第一部分是什麼——是的。在定價方面，我們不准備詳細討論價格。 Cologuard 2.0 或下一代 Cologuard 更進一步，其價值顯著增加，因為誤報率減少了 30%。假陽性會導致不必要的大腸鏡檢查、不必要的併發症等，從而導致成本增加和護理減少。

So by eliminating those, 30% of all false positives, it gives tremendous value to commercial payers and to Medicare. So those are conversations that we plan to have. It's too early to tell where that will go. But we'll talk more about those plans as we head into 2025 when we launch Cologuard 2.0, next gen.

因此，透過消除這些誤報（佔所有誤報的 30%），它可以為商業付款人和醫療保險帶來巨大的價值。這些是我們計劃進行的對話。現在判斷其去向還為時過早。但當我們進入 2025 年時，我們將更多地討論這些計劃，屆時我們將推出下一代 Cologuard 2.0。

Derik, thanks for the question. This is Jeff. Even without a change in pricing for 2.0, we expect incremental revenue to Exact Sciences because, as Kevin mentioned, a reduction in false positives means more patients stay with Exact Sciences and Cologuard over time. So it should really help the rescreen business, which is doing well today, and I think it can do even better going forward.

德里克，謝謝你的提問。這是傑夫。即使 2.0 的定價沒有變化，我們也預期 Exact Sciences 的收入會增加，因為正如 Kevin 所提到的，誤報的減少意味著隨著時間的推移會有更多的患者繼續使用 Exact Sciences 和 Cologuard。因此，它應該確實有助於重新篩選業務，該業務目前表現良好，我認為它未來可以做得更好。

Also to remind you, the cost of goods for 2.0, we expect to be at least 5% below what we see today. So that should help -- that's the per test cost of goods. So that should help both the revenue growth and margin profile.

另外要提醒您的是，2.0 的商品成本預計將比今天低至少 5%。所以這應該會有所幫助——這是每次測試的商品成本。因此，這應該有助於收入成長和利潤率狀況。

To your second question on rescreens. Rescreens, we had a good quarter. The team is doing a very nice job managing through the headwind that we faced this year. And the headwind, to remind folks on the call, relates back to 2020 when COVID first hit. That led to a temporary pause in people getting screens. So now three years later, as people are looking to do or would normally look to do a rescreen for Cologuard, we see a bit of a headwind. That's about a $50 million headwind to the business this year. So again, the team is doing a nice job of navigating that.

關於重試的第二個問題。重新篩選，我們度過了一個美好的季度。該團隊在應對今年面臨的逆風方面做得非常好。提醒與會者的是，這場逆風可以追溯到 2020 年新冠疫情首次爆發時。這導致人們暫時停止觀看螢幕。因此，三年後的今天，當人們希望或通常希望對 Cologuard 進行重新篩選時，我們看到了一些阻力。這對今年的業務來說大約是 5000 萬美元的阻力。再說一次，團隊在這方面做得很好。

When you look at the number of new patients who are becoming eligible for rescreens this year, it's 1.2 million. That's the same as what it was last year. However, when you look ahead to next year, it jumps up to 1.6 million. So not only are we improving our success rate at getting more people rescreened, the pool of patients is also growing, who are eligible for rescreening.

如果你看看今年有資格接受重新篩檢的新患者人數，你會發現有 120 萬人。這與去年的情況相同。然而，當你展望明年時，這個數字會躍升至 160 萬。因此，我們不僅提高了讓更多人接受重新篩檢的成功率，而且有資格接受重新篩檢的患者數量也在增加。

And Jeff, I'll just add something. Commercial -- it's a great example of our commercial organization from a rescreen execution standpoint. Our field force it's one of their major messages to our providers that are out there. From a marketing standpoint, we have specific marketing materials for the rescreen population. And then from a customer experience standpoint, we're actually reaching out to those patients that are super overdue from a rescreen population through text messaging, through phone calls, through e-mails and making sure that we remind them that they are up for their date. So that focus has been really, really solid in '23, and we're looking to continue that in '24.

傑夫，我要補充一些東西。商業－從重新篩選執行的角度來看，這是我們商業組織的一個很好的例子。我們的現場人員這是他們向我們的供應商傳達的主要訊息之一。從行銷的角度來看，我們有針對重新篩選人群的特定行銷資料。然後，從客戶體驗的角度來看，我們實際上是透過簡訊、電話、電子郵件來接觸那些超逾期重新篩選人群的患者，並確保我們提醒他們，他們已經做好了準備。日期。因此，這個重點在 23 年非常非常牢固，我們希望在 24 年繼續這樣做。

We'll go next now to Dan Brennan at TD Cowen.

接下來我們將請來 TD Cowen 的 Dan Brennan。

Congrats, Megan. So maybe 2-parter, first would just be on Cologuard. You've had 30%, I think, plus growth the last couple of years. You just talked about the rescreen opportunity being even greater next year given the headwinds. So just wondering is there are any factors that you would see today that would slow down the 30% type growth rate as we look ahead?

恭喜，梅根。所以也許是兩人合作，首先是在 Cologuard。我想，過去幾年你已經有了 30% 的成長。您剛才談到，考慮到不利因素，明年重新篩選的機會會更大。那麼，我想知道，當我們展望未來時，您今天會看到哪些因素會減緩 30% 的成長率？

And then b, could you just provide an update on MRD? I know in Q2, you gave some color in terms of the launch timing and then the time it would take the coverage and things of that nature, but just wondering if you can just update us on how we should be thinking about the breast launch and then the colorectal launch.

然後 b，您能否提供 MRD 的最新情況？我知道在第二季度，您在發佈時間方面給出了一些顏色，然後是覆蓋範圍和此類性質的時間，但只是想知道您是否可以向我們更新我們應該如何考慮乳房發布和然後是結腸直腸發射。

Why don't I start with this, Dan, thanks. MRD will, as we mentioned in the earlier comments, will be available for colon cancer at the -- by the end of this year and breast cancer next year in terms of a MALDI X submission that will occur next year for colon cancer screening and most likely breast cancer the year after. Jeff, why don't you take the other question.

我為什麼不從這個開始，丹，謝謝。正如我們在先前的評論中提到的，MRD 將在今年年底前用於結腸癌，明年將用於乳腺癌，根據MADI X 提交，該提交將於明年用於結腸癌篩檢和大多數癌症後年可能罹患乳癌。傑夫，你為什麼不回答另一個問題？

Sure. I'll take the one on Cologuard. Kevin and Everett have talked about some of the things we're doing commercially to keep that growth going. And look, we have very broad-based momentum. There are 60 million people unscreened. And our goal, as you well know, is to get to at least $7 billion of revenue long term. So we expect many years of robust growth ahead. Back in June, we guided to total company revenue growth of 15% about from the period of 2022 through 2027. What they're really implied was Cologuard growth a bit faster than that and then some of the other non-Cologuard areas growing a bit slower.

當然。我會選擇 Cologuard 上的那個。凱文和埃弗雷特談到了我們為保持成長而在商業上所做的一些事情。看，我們有非常廣泛的勢頭。有 6000 萬人沒有接受篩檢。如您所知，我們的目標是長期實現至少 70 億美元的收入。因此，我們預計未來將出現多年的強勁成長。早在6 月，我們就預計從2022 年到2027 年，公司總收入成長約15%。他們真正暗示的是Cologuard 的成長速度比這要快一些，然後其他一些非Cologuard 領域的成長速度也稍快一些。慢點。

So obviously, over time, with the law of large numbers kicking in from a growth rate standpoint, yes, we expect it to grow -- to slow down. But over time, we expect very sustainable double-digit growth, which is what we guided to back in June.

顯然，隨著時間的推移，從成長率的角度來看，大數定律開始發揮作用，是的，我們預期它會成長——放緩。但隨著時間的推移，我們預計將實現非常可持續的兩位數成長，這正是我們在 6 月的指導方針。

We'll go next now to Andrew Brackmann at William Blair.

接下來我們將採訪威廉布萊爾的安德魯布拉克曼。

Congrats to Megan. I wanted to ask on Resolution Bio. It seems like a nice tuck-in business for you guys. Can you maybe just sort of talk about the rationale there broadly? And then also, just as it relates to M&A and capital allocation, anything that you would call out with respect to changes in your philosophy there as we look to 2024?

恭喜梅根。我想問關於決議生物。對你們來說，這似乎是一門不錯的休閒生意。您能否大致談談其中的基本原理？然後，正如它與併購和資本配置相關一樣，當我們展望 2024 年時，您對您的理念有何變化有何看法？

No change to our perspective on capital allocation in terms of our acquisition of Resolution Bio. It's a very strong company with a culture of innovation, and they have an amazing liquid biopsy test. We believe it's going to be a home run of an acquisition for us over the long [haul]. The quality of their therapies selection test complements OncoExTra, which is our solid tumor tissue test for therapy selection. Liquid is a preferred solution in many situations, enabling faster turnaround times. And it also helps us expand our biopharma opportunity as a CDx port, non-small cell lung cancer.

就我們收購Resolution Bio而言，我們對資本配置的看法並沒有改變。這是一家非常強大的公司，擁有創新文化，他們擁有令人驚嘆的液體活檢測試。我們相信，從長遠來看，這將是我們一次收購的全壘打。他們的療法選擇測試的品質與 OncoExTra 相輔相成，OncoExTra 是我們用於療法選擇的實體腫瘤組織測試。在許多情況下，液體是首選解決方案，可以縮短週轉時間。它還幫助我們擴大作為非小細胞肺癌伴隨診斷端口的生物製藥機會。

So the next steps here are to generate evidence and submit to MALDI X for reimbursement, make this available through our Oncotype DX or Precision Oncology commercial organization and continue to deliver additional new tests to the oncologists that are such strong customers. So we're thrilled about this acquisition. It's a great team in the Seattle, Washington area, high-quality people that add to the culture and capabilities of Exact Sciences.

因此，接下來的步驟是產生證據並提交給 MALDI X 進行報銷，透過我們的 Oncotype DX 或 Precision Oncology 商業組織提供這些證據，並繼續向作為強大客戶的腫瘤學家提供額外的新測試。因此，我們對此次收購感到非常興奮。這是華盛頓州西雅圖地區的一支優秀團隊，高素質的人才增強了 Exact Sciences 的文化和能力。

We'll go next now to Vijay Kumar at Evercore ISI.

接下來我們將採訪 Evercore ISI 的 Vijay Kumar。

Kevin -- actually, I had a 2-parter, Kevin, one on MRD here. Can you just compare in contrast with screening when you think about the launch curve, what's the level of evidence? How should we think about the launch curve. Screening you need USPSTF recommendation, et cetera. How does it work in MRD? And Jeff, on the guidance here, did the guide rates include Resolution Biosciences, and if you don't mind quantifying if it does include.

凱文 - 事實上，我有一個 2 人，凱文，其中一個在 MRD 上。當您考慮啟動曲線時，您能否將其與篩選進行比較，證據等級如何？我們應該如何考慮啟動曲線。篩選你需要USPSTF推薦等等。它在 MRD 中如何運作？傑夫，在此處的指導中，指導率是否包括分辨率生物科學，如果您不介意量化它是否包括。

So Vijay, why don't I start with the second one and then Kevin. Let me just jump in and clarify the first question, Vijay, on -- when you're talking about screening and MRD, do you mean screening and multi-cancer early detection? Or do you mean screening and MRD. I think you probably meant screening and MCED.

那麼維傑，我為什麼不從第二個開始，然後是凱文。讓我先澄清第一個問題，Vijay，當您談論篩檢和 MRD 時，您是指篩檢和多癌症早期檢測嗎？或者你的意思是篩檢和MRD。我想你可能指的是篩檢和 MCED。

Yes. What I meant was when you compare and contrast those 2 different end markets, it seems like in screening MCED, a lot of evidence data. How does that work in MRD? Do you need some data sets to make this commercially successful? What drives success in MRD?

是的。我的意思是，當你比較和對比這兩個不同的終端市場時，似乎在篩選 MCED 時，需要大量證據數據。這在 MRD 中是如何運作的？您是否需要一些資料集才能使其在商業上取得成功？是什麼推動 MRD 取得成功？

Okay. I understand it better. Jeff, do you want to take your piece and I'll take the other.

好的。我更明白了。傑夫，你想拿走你的一塊嗎，我拿另一塊。

Sure. I'll take the guidance question. So Res Bio, from a revenue standpoint, not material. So there's no contribution into the guide. So the guide raise was based on the strength of the core business.

當然。我將回答指導問題。所以Res Bio，從收入的角度來看，不是物質的。因此，該指南沒有任何貢獻。因此，指導性加薪是基於核心業務的實力。

So MRD evidence is developing at a rapid clip. Many studies in the U.S. and around the world are occurring because of the promise of being able to answer 2 questions. Number one, post initial treatment, is there still tumor present? Did the surgeon, did the oncologist, did the treatment get all of the cancer? And then the second question that MRD testing answers is has the cancer returned? Has it recurred? So what is the evidence that is being developed? There are a number of prospective studies that are occurring globally. And I think the question is, is that going to occur on a tumor type by tumor type? Or is it going to occur like it did with therapy selection where, after a few tumors were proven out -- tumor types were proven out, that there was widespread utilization.

因此，MRD 證據正在快速發展。美國和世界各地正在進行許多研究，因為它們有望回答兩個問題。第一，初次治療後，腫瘤是否仍存在？外科醫師、腫瘤科醫師的治療是否治癒了所有癌症？ MRD 檢測回答的第二個問題是癌症是否復發？又復發了嗎？那麼正在開發的證據是什麼？全球範圍內正在進行許多前瞻性研究。我認為問題是，這種情況會發生在不同的腫瘤類型嗎？或者它會像治療選擇一樣發生，在一些腫瘤被證明之後——腫瘤類型被證明，然後被廣泛使用。

We are starting to see signs of the latter that there will be enough evidence developed that MRD testing will be used broadly. So it's very different than the screening markets, which are unlocked generally by one group, called the United States Preventive Services Task Force. In MRD, in oncology, there's a number of different guidelines that will come into play. We are making progress in terms of our own studies to support our MRD test, and we think this is going to be a huge change in oncology, a huge market and one that we're excited to participate in.

我們開始看到後者的跡象，表明將有足夠的證據表明 MRD 檢測將被廣泛使用。因此，這與篩檢市場有很大不同，篩檢市場通常由一個名為「美國預防服務工作小組」的組織來解鎖。在 MRD 和腫瘤學領域，有許多不同的指南將發揮作用。我們在支持 MRD 測試的研究方面正在取得進展，我們認為這將是腫瘤學的巨大變化，這是一個巨大的市場，我們很高興能夠參與其中。

We'll go next now to Matt Sykes at Goldman Sachs.

接下來我們請高盛的 Matt Sykes 發言。

Congrats, Megan. Maybe one for Everett, just on the commercial penetration. In previous quarters, you've given some pretty good color on health system penetration. I don't know if there's any update on that. And then secondarily, related to that, there's obviously a lot of opportunity given the penetration rate where today and where you want to get to. Could you kind of like prioritize the white space opportunities that you provide for your commercial team in terms of what they're going after over the course of the next 1 to 2 years?

恭喜，梅根。也許埃弗雷特就是其中之一，只是關於商業滲透率。在前幾個季度，您對衛生系統的滲透率給出了一些相當不錯的描述。我不知道這方面是否有任何更新。其次，與此相關的是，考慮到今天的滲透率以及您想要達到的目標，顯然存在許多機會。您能否根據商業團隊在未來 1 到 2 年內追求的目標，優先考慮為您提供的空白機會？

Yes. Thanks for the question. Yes, our health system volume continues to be our largest lever of growth this year. We knew that, and that's why we put additional resources on the Health Systems side, we more than doubled our team in Health Systems. And we're also finding a different type of shift or dynamic in the Health Systems to where we're actually calling on Health Systems. We're going to always do that. But we're also -- Health Systems are actually requesting meetings with us, because they know and Kevin said it that the capacity of screening colonoscopies is relatively fixed at 6 million per year, and Health Systems are saying, we need help. And this colonoscopy alone strategy is not going to get us there.

是的。謝謝你的提問。是的，我們的衛生系統數量仍然是我們今年最大的成長槓桿。我們知道這一點，這就是為什麼我們在衛生系統方面投入了更多資源，我們的衛生系統團隊人數增加了一倍以上。我們還發現衛生系統發生了與我們實際呼籲的衛生系統不同類型的轉變或動態。我們將永遠這樣做。但我們也 - 衛生系統實際上要求與我們會面，因為他們知道，凱文說，篩檢大腸鏡檢查的能力相對固定為每年 600 萬，衛生系統說，我們需要幫助。僅靠大腸鏡檢查策略無法幫助我們實現這一目標。

So we have several health systems that have documented that, hey, listen, it's average risk patient, first-line Cologuard will be used, and we're seeing volume go up that way. So we're really happy about that. Also, I look at it as a multipronged approach of good product, but we also have to make it easier for health systems to write and order Cologuard. And as we said, 70% of our Cologuard orders are coming in electronically. And what I like about that is we're not going to stop there. We know that there are additional targets to get this year and next year. And if we can make it easier to prescribe or to order Cologuard, we know that we're going to be even a better partner moving forward.

因此，我們有幾個衛生系統已記錄，嘿，聽著，這是平均風險患者，將使用一線 Cologuard，我們看到數量以這種方式增加。所以我們對此感到非常高興。此外，我將其視為優質產品的多管齊下方法，但我們也必須讓衛生系統更輕鬆地編寫和訂購 Cologuard。正如我們所說，我們 70% 的 Cologuard 訂單都是透過電子方式收到的。我喜歡的是我們不會就此止步。我們知道今年和明年還有更多目標需要實現。如果我們能讓開處方或訂購 Cologuard 變得更容易，我們知道我們將成為一個更好的合作夥伴。

As far as in the future, we see -- we know that there's a lot of opportunity. As we stated earlier, we're only 10% penetrated with Cologuard. There's 60 million people that are not up to date with their screening. A lot of those people sit in that health systems segment. And I really like the way that we're structured now at Exact Sciences, with reaching out the health systems, talking to the C-suite, making sure that we can get unique partnerships and how that falls through to the affiliated physicians in those geographies, we're perfectly structured to continue to make this a growth lever.

就未來而言，我們知道存在著許多機會。正如我們之前所說，Cologuard 的滲透率僅為 10%。有 6000 萬人沒有及時進行篩檢。其中很多人都屬於衛生系統部門。我真的很喜歡 Exact Sciences 現在的組織方式，與衛生系統接觸，與最高管理層交談，確保我們能夠獲得獨特的合作夥伴關係，以及如何將這種合作關係落實到這些地區的附屬醫生身上，我們的結構完美，可以繼續使其成為成長槓桿。

We'll go next now to Patrick Donnelly at Citi.

接下來我們請花旗銀行的 Patrick Donnelly 發言。

Jeff, maybe one just on the expense side on the go forward. Can you help us think about just the moving pieces as we work our way into '24? Obviously, some trials that wrapped up this year, some trials that maybe ramp up next year. Maybe touch on the SG&A piece. I know historically, you felt that it's clearly going to grow. Expenses definitely going to grow below revs. But is that kind of low, mid-single digit the right area to think about on expenses? And then a very quick follow-up. Just I think you called out some pull forward on revs in 3Q. If you could just quantify it, that would be great. .

傑夫，也許只是在繼續前進的費用方面。您能否幫助我們思考進入 24 世紀的那些令人感動的事情？顯然，一些試驗今年結束，一些試驗可能會在明年加速。也許可以談談SG&A 部分。我知道從歷史上看，你會覺得它顯然會成長。費用肯定會成長到低於轉速。但這種低中個位數的支出是否是值得考慮的正確領域？然後是非常快速的跟進。只是我認為您在第三季提出了一些轉速的提升。如果你能量化它，那就太好了。 。

Sure. Thanks, Patrick. This is Jeff. We typically provide guidance on our February call, which is that's when we do plan to provide it for now. But over time, you can think about continued very good expense discipline across the board. You want on the full P&L on gross margin. I mean many of you saw the tour of our lab this summer. That team has done a fantastic job finding ways to increase efficiencies, automate more tasks and scale the business.

當然。謝謝，派崔克。這是傑夫。我們通常會在二月的電話會議上提供指導，我們目前確實計劃在那時提供指導。但隨著時間的推移，您可以考慮繼續全面實施良好的支出紀律。您需要毛利率的完整損益表。我的意思是，今年夏天你們很多人參觀了我們的實驗室。團隊在尋找提高效率、自動化更多任務和擴展業務的方法方面做得非常出色。

So I'd expect continued steady gross margin improvement. This year, we're tracking in that 73.5% to 74% range, probably towards the higher end. So no change there. But over time, I expect this to get to -- our goal is 80%. When you look at sales and marketing, Everett and the team have done a very nice job focusing on the highest impact areas to grow this business. And so now you see the result of that 2 years in a row with sales and marketing down in absolute terms.

因此，我預計毛利率將持續穩定改善。今年，我們的目標是 73.5% 到 74% 的範圍，可能會趨向高端。所以那裡沒有變化。但隨著時間的推移，我預計我們的目標是 80%。當你看看銷售和行銷時，埃弗里特和團隊做得非常好，專注於發展這項業務的影響最大的領域。現在您可以看到銷售和行銷的絕對值連續兩年下降的結果。

Now on a go-forward basis, as we launch new products, I expect us to start to reinvest in sales and marketing. So that will grow in dollar terms, but I think we'll manage it down on a percent of revenue basis.

現在，展望未來，隨著我們推出新產品，我預計我們將開始在銷售和行銷方面進行再投資。因此，以美元計算，這將會成長，但我認為我們會根據收入的百分比來管理它。

R&D, I look at that as more project by project. You know as well that we scrutinize all of our R&D investments, to make sure they carry very good ROIs. I think we'll continue to do that. That has been a hallmark of Exact. So over time, you may see some movement there. A big one would be our multi-cancer study. If we see that pathway forward from Congress for reimbursement for Medicare, that would help us then make the decision to move forward with a big study in MCED. So that study would lead to a higher growth rate temporarily. But over time, I think you can see R&D coming down as a percent of revenue pretty steadily, barring the kind of the one-off studies.

研發，我將其視為一個又一個專案。您也知道，我們會仔細檢視所有研發投資，以確保它們帶來非常好的投資報酬率。我想我們會繼續這樣做。這是 Exact 的標誌。因此，隨著時間的推移，您可能會看到那裡發生一些變化。其中一項重大研究是我們的多種癌症研究。如果我們看到國會在醫療保險報銷方面取得了進展，那將有助於我們做出在 MCED 中推進一項大型研究的決定。因此這項研究將暫時導致更高的成長率。但隨著時間的推移，我認為你可以看到研發佔收入的百分比相當穩定地下降，除非是一次性研究。

G&A is an area that there's been a lot of focus for us. It's an area that I do expect over time to see probably the most incremental leverage from here. The biggest areas of investment have been building out this foundation. This foundation that has served us so well to get the first $1 billion diagnostic to market and, over time, support multiple billion dollar diagnostics. Our longer-term goal is to get G&A down to the 10% to 12% of revenue range. To do that, we have to keep automating. That is a challenge to the broader Exact Sciences team, finding ways to continue to drive efficiencies. So over the next 5 years or so, I think that's going to be the biggest area of improvement, to drive margin expansion.

G&A 是我們非常關注的一個領域。我確實期望隨著時間的推移，這個領域可能會看到最大的增量槓桿。最大的投資領域是建立這個基礎。這個基金會為我們提供了很好的幫助，使第一個 10 億美元的診斷產品進入市場，並隨著時間的推移，支持數十億美元的診斷產品。我們的長期目標是將 G&A 降低至收入的 10% 至 12%。為此，我們必須保持自動化。這對更廣泛的 Exact Sciences 團隊來說是一個挑戰，他們需要尋找繼續提高效率的方法。因此，在未來 5 年左右的時間裡，我認為這將是最大的改進領域，以推動利潤率擴張。

We'll go next now to Jack Meehan at Nephron Research.

接下來我們請來 Nephron Research 的 Jack Meehan。

Kevin, it would be great to get your latest thoughts on the competitive landscape for CRC screening. There were some additional updates at ACG from another school-based competitor. Would just love to get your thoughts on what that might mean, if anything, for you guys.

Kevin，很高興能了解您對 CRC 篩檢競爭格局的最新想法。 ACG 上還有來自另一所學校競爭對手的一些額外更新。只是想聽聽你們的想法，這對你們來說可能意味著什麼（如果有的話）。

Ever since I've been with Exact Sciences, there's been a litany of aspiring entrants into this field. There is just a long list of things you need to do to get into the field. And first of all, you need high-quality products, high-quality studies, high-quality data published. You need to get through the gauntlet of FDA, Medicare, CMS, United States Preventive Services Task Force, USPSTF, quality measure inclusion, commercial insurers. And we've yet to see any of these aspiring entrants get past first base there, namely high-quality evidence in high-quality study. So there's a lot of work to be done for these folks before they will earn the ability to serve patients and physicians. And other than that, I'm not going to -- we're not going to comment on other people's studies.

自從我加入 Exact Sciences 以來，已經有很多有抱負的人進入這個領域。要進入這個領域，您需要做的事情只有一長串。首先，你需要高品質的產品、高品質的研究、高品質的數據發布。您需要通過 FDA、Medicare、CMS、美國預防服務工作小組、USPSTF、品質衡量標準、商業保險公司的考驗。我們還沒有看到這些有抱負的參賽者中的任何一個通過那裡的一壘，即高品質研究中的高品質證據。因此，在這些人獲得為病人和醫生服務的能力之前，他們還有很多工作要做。除此之外，我不會——我們不會評論其他人的研究。

We'll go next now to Puneet Souda at Leerink.

接下來我們要去 Leerink 的 Puneet Souda。

Good luck to Megan. So Kevin, following up on the sort of the competition side, just wondering how should we think about sort of the timing for Cologuard Blood? Where is the positioning of that? Any updated thoughts on the positioning of Cologuard Blood as a product? And just wondering if you have any updated thoughts on blood-based assays that are potentially suggesting improvements in advanced adenoma. We haven't seen the data yet, but remains to be seen. .

祝梅根好運。凱文（Kevin）跟進了比賽方面的情況，只是想知道我們應該如何考慮 Cologuard Blood 的時機？它的定位在哪裡？關於 Cologuard Blood 作為產品的定位有什麼最新的想法嗎？只是想知道您是否對基於血液的檢測有任何最新的想法，這些檢測可能表明晚期腺瘤的改善。我們還沒有看到數據，但仍有待觀察。 。

No update here. We've talked about this field for a long time. The data that we've seen to date has been very impressive in terms of pre-cancer detection or in terms of specificity. So hard to see how this class of tests makes it into the guidelines and into commercial viability reimbursed by commercial insurers. So there's really no update there in terms of the -- those who hope to get into the field. We have our own test, as we've articulated. There are many people who refuse a colonoscopy, refuse a Cologuard test and still need to be screened.

這裡沒有更新。我們已經談論這個領域很久了。到目前為止，我們看到的數據在癌前檢測或特異性方面非常令人印象深刻。很難看出此類測試如何納入指導方針以及商業保險公司報銷的商業可行性。因此，對於那些希望進入該領域的人來說，確實沒有任何更新。正如我們所闡明的，我們有自己的測試。有很多人拒絕接受大腸鏡檢查、拒絕 Cologuard 測試，但仍需要接受篩檢。

And so we know who those people are. They are in our massive database and the only national database of colon cancer screening of its size and accuracy. So we're able to reach out to patients who, for example, refuse frontline screening tests like colonoscopy or Cologuard, and help get those people screened. And we think that there is a need to address there. And we believe that our test is going to be able to meet that need. In terms of when to expect to see that data, again, that's next year. Likely, we will complete that study mid-year and then make the data available thereafter. So that's where we are with blood-based colon cancer screening.

所以我們知道那些人是誰。它們位於我們的龐大資料庫中，也是規模和準確性方面唯一的國家大腸癌篩檢資料庫。因此，我們能夠接觸那些拒絕大腸鏡檢查或 Cologuard 等第一線篩檢測試的患者，並幫助他們進行篩檢。我們認為有必要解決這個問題。我們相信我們的測試將能夠滿足這項需求。至於什麼時候可以看到這些數據，那就是明年了。我們可能會在年中完成研究，然後提供數據。這就是我們以血液為基礎的大腸癌篩檢的現況。

We'll go next now to Dan Arias at Stifel.

接下來我們將採訪 Stifel 的 Dan Arias。

I wanted to just ask a follow-up on rescreening. Everett, at the Analyst Day, you talked about a pilot program that you guys have, where you're auto mailing kits directly to the patients as their recommended screening date arrives. Is that something that you think might get deployed more broadly? And if so, do you think that could start to move the needle on volumes, just given that it seems for rescreeners that would be pretty receptive to that idea.

我只想詢問有關重新篩選的後續情況。埃弗雷特，在分析師日，您談到了你們的一個試點計劃，在患者建議的篩檢日期到來時，您會自動將試劑盒直接郵寄給患者。您認為這可能會得到更廣泛的部署嗎？如果是這樣，您是否認為這可能會開始推動銷售的成長，因為重新篩選者似乎很容易接受這個想法。

Yes. Thanks, Dan. And just a clarification. It's not an auto mail, even though it might be a non-point-of-care visit, it's still a prescription. And I go back to this -- these are -- from a rescreen population, these are different ways that we're partnering with health systems, with payers, with physicians in terms of getting hard to screen patients to screen. Whether it's the rescreen population, the 45 to 49 or just the general population. We're happy that we can do these different partnerships, and we'll continue to partner differently with health systems.

是的。謝謝，丹。只是一個澄清。這不是自動郵件，儘管它可能是非現場護理就診，但它仍然是處方。我回到這一點——這些是——從重新篩檢人群來看，這些是我們與衛生系統、付款人、醫生合作的不同方式，以加強對患者進行篩檢的難度。無論是重新篩檢人群、45 至 49 歲人群或一般人群。我們很高興能夠建立這些不同的夥伴關係，並且我們將繼續與健康系統進行不同的合作。

Again, I go back to a lot of these different partnerships are being generated by the health systems themselves, and they know that we're a good partner because of what we have. Our sales arm, our marketing arm, the way in which our customer call center can reach out to patients and remind them the importance of rescreening, our advanced order workflow we have there. So they like that.

我再說一遍，許多不同的夥伴關係是由健康系統本身產生的，他們知道我們是一個很好的合作夥伴，因為我們擁有的東西。我們的銷售部門，我們的行銷部門，我們的客戶呼叫中心聯繫患者並提醒他們重新篩檢的重要性的方式，我們在那裡擁有的先進的訂單工作流程。所以他們喜歡這樣。

And then secondly, we're a 3-year interval versus FIT, which is a 1-year interval where they've been using these different reach out care gap programs. So now they're looking at us and they're finding that we're a better partner, we'll continue these throughout the rest of the year and years to come.

其次，我們與 FIT 的間隔為 3 年，FIT 的間隔為 1 年，他們一直在使用這些不同的外展照護缺口計畫。所以現在他們正在關注我們，他們發現我們是一個更好的合作夥伴，我們將在今年剩餘時間和未來幾年繼續這些。

We'll go next now to Dan Leonard at UBS.

接下來我們請瑞銀集團的 Dan Leonard 發言。

Kevin, I'd love to learn how or if you're planning for additional FDA oversight of LDTs, specifically in your Precision Oncology business? And what do you think are the implications?

Kevin，我很想知道您如何或是否計劃對 LDT 進行額外的 FDA 監督，特別是在您的精準腫瘤學業務中？您認為這意味著什麼？

We do have a lab-developed test, Oncotype DX is a lab-developed test. And because of the level of evidence that we have with Oncotype DX, that would not be a huge burden for us to make a submission, the quality standards that, that test has undergone. We've already submitted for IVDR and CE marking for that test. So the quality system there is incredibly strong.

我們確實有實驗室開發的測試，Oncotype DX 是實驗室開發的測試。由於我們擁有 Oncotype DX 的證據水平，提交該測試所經過的品質標準對我們來說不會是一個巨大的負擔。我們已經提交了該測試的 IVDR 和 CE 標誌。所以那裡的品質系統非常強大。

The interesting thing about the proposed LDT regulation is that Exact Sciences was built as a PMA or IDD company because of Cologuard. That means that the people, the incredibly complex systems, data that is collected, processes that you follow, from quality systems and manufacturing to good manufacturing processes and all that goes into that, that's who we are as a company. So we are better suited than anybody really in our field of advanced diagnostics to be able to comply with the proposed lab-developed regulations. That puts us in a good position because we do have those people and systems in place to succeed.

擬議的 LDT 法規的有趣之處在於，Exact Sciences 是因為 Cologuard 而成為 PMA 或 IDD 公司。這意味著人員、極其複雜的系統、收集的數據、遵循的流程，從品質系統和製造到良好的製造流程以及其中的所有內容，這就是我們作為一家公司的本質。因此，我們比先進診斷領域的任何人都更適合遵守擬議的實驗室制定的法規。這使我們處於有利地位，因為我們確實擁有能夠取得成功的人員和系統。

So although we have our view on lab-developed test regulation and there -- we believe that it would have been better, and we still hope that Congress steps in and passes the Valid Act. We are very well prepared to be able to comply with the proposed LDT regulations.

因此，儘管我們對實驗室開發的測試法規有自己的看法，但我們相信它會更好，我們仍然希望國會介入並通過有效法案。我們已做好充分準備，能夠遵守擬議的 LDT 法規。

We'll go next now to Mark Massaro at BTIG.

接下來我們請 BTIG 的 Mark Massaro 發言。

Congrats on the progress. Just a 2-parter. It looks like you invested about $54 million to acquire Resolution Biosciences. I would just be curious, as you think about valuations being down in the space, whether or not you have an appetite to do something larger? And then on the second part, you guys have indicated plans to soon launch MRD and CRC in breast in 2024. Obviously, both solid tumors. Can you just give us a sense of how you view the opportunity in MRD in blood cancers?

祝賀取得的進展。只是2人組。您似乎投資了約 5,400 萬美元來收購 Resolution Biosciences。我只是好奇，當您考慮該領域的估值下降時，您是否有興趣做更大的事情？然後在第二部分中，你們已經表示計劃很快在 2024 年推出乳腺 MRD 和 CRC。顯然，都是實體瘤。您能否向我們介紹一下您如何看待 MRD 在血癌中的機會？

In terms of M&A, our view hasn't changed there. We have a disciplined approach to the way we think about this that falls around our capital allocation processes. We look at, number one, core growth. We'd take a look at our pipeline. We look at retaining cash flow. That's a -- in terms of capital allocation. We're highly focused on continuing to grow Cologuard, investing in Cologuard and Cologuard growth, and Oncotype DX growth internationally. Both provide significant returns on investments.

在併購方面，我們的觀點並沒有改變。我們對資本配置流程的思考方式有一套嚴格的方法。我們關注第一，核心成長。我們會看看我們的管道。我們著眼於保留現金流。這是－就資本配置而言。我們高度關注 Cologuard 的持續成長，投資於 Cologuard 和 Cologuard 的成長以及 Oncotype DX 在國際上的成長。兩者都能提供可觀的投資回報。

In terms of our process around M&A, we look at what can help us accelerate our mission, what is the right culture fit, what creates value. And we're -- we just don't comment on any particular regions. We think it's probably irresponsible for those to guess at what we may do or not do. And because we have a disciplined approach to the way we look at these things.

就我們的併購流程而言，我們著眼於什麼可以幫助我們加速我們的使命，什麼是正確的文化契合度，什麼可以創造價值。我們只是不對任何特定地區發表評論。我們認為，讓那些猜測我們可能做什麼或不做什麼的人可能是不負責任的。因為我們看待這些事情有嚴格的方法。

And in terms of Res Bio, that's a great example. We had a need for a liquid biopsy therapy selection test. We had an internal program that eventually we were going to get around to and a test was available through Res Bio that met those needs, that accelerated our mission in our core solid tumor business. It was a great fit culturally, amazing innovator, scientists, bioinformaticians. And we believe it's going to create value over the long haul. So I think that's kind of right up the alley of the way that we think about things.

就 Res Bio 而言，這是一個很好的例子。我們需要進行液體活檢療法選擇測試。我們有一個內部計劃，最終我們將抽出時間進行，並且透過 Res Bio 提供了滿足這些需求的測試，這加速了我們在核心實體瘤業務中的使命。它在文化上非常契合，是令人驚嘆的創新者、科學家、生物資訊學家。我們相信，從長遠來看，它將創造價值。所以我認為這正是我們思考事物的方式。

We'll go next now to Kyle Mikson at Canaccord.

接下來我們將採訪 Canaccord 的 Kyle Mikson。

Congrats on the quarter. Congrats to Megan and great to hear on the new role. So in the updated '23 revenue guidance, it is implied annual screening growth is about 30%. That's the (inaudible) is modeling 16% year-over-year for screening next year? I know you're going to talk about that more early next year, but is that too far of a step down in growth rate considering it looks like the jumping off point in 4Q is going to be over 20%, if you account for that rescreen headwind?

恭喜本季。恭喜梅根，很高興聽到這個新角色。因此，在更新的 23 年收入指引中，暗示年度放映成長約為 30%。這就是（聽不清楚）明年篩選的模型年增率為 16%？我知道你會在明年初更多地談論這個問題，但考慮到第四季度的起點將超過 20%（如果考慮到這一點），增長率下降幅度是否太大了？重新篩選逆風？

Look -- Kyle, this is Jeff. There's a question earlier about, is there anything changing on the landscape? And the answer to that is no. The -- in fact, as you heard today, we're very confident in not only next year, but the growth opportunity for many years to come. And part of why is we've got the best team in diagnostics. We've got the highest quality of evidence. And there's a massive, massive unmet need that won't be met in 1 year. It won't be met in 5 years. There's 60 million people out there with more entering every day. About 10,000 new people age into this market every day.

看——凱爾，這是傑夫。之前有一個問題是，情況有什麼改變嗎？答案是否定的。事實上，正如您今天所聽到的，我們不僅對明年充滿信心，而且對未來許多年的成長機會充滿信心。部分原因是我們擁有最好的診斷團隊。我們擁有最高品質的證據。還有大量未滿足的需求在一年內無法滿足。 5年之內都見不到了。那裡有 6000 萬人，而且每天都有更多人進入。每天大約有 10,000 名新人進入這個市場。

So we're very optimistic on the growth. From a growth rate standpoint, though, the law of large numbers is going to kick in and we'll have that growth rate come down. But as you can see this year, we're guiding to over $420 million of incremental revenue, the best yet. And Exact Sciences has been around for a while. So I think from a growth incremental dollar standpoint, very optimistic here. From a percentage standpoint, it's going to come down as it would with any company as they grow.

所以我們對成長非常樂觀。不過，從成長率的角度來看，大數定律將會發揮作用，成長率將會下降。但正如您所看到的，今年我們預計增量收入將超過 4.2 億美元，這是迄今為止最好的。精確科學已經存在一段時間了。因此，我認為從美元成長增量的角度來看，這裡非常樂觀。從百分比的角度來看，隨著任何公司的成長，它都會下降。

We'll go next now to [E. Berstein] at Bernstein.

我們現在將前往[E.伯斯坦]在伯恩斯坦。

Two part. The first is you'd called out capacity constraints on colonoscopies when you talked about your health system partnerships. Obviously, these have always existed in some geographies, but the problem is definitely exacerbated by this influx of 45- to 49-year-old patients that are suddenly eligible for screening. So can you talk about how that dynamic is evolving? And is this something that's giving you like a onetime bump in growth, but isn't sort of a durable driver of growth going forward?

兩部分。首先，當您談到衛生系統合作夥伴關係時，您指出了大腸鏡檢查的能力限制。顯然，這些問題在某些地區一直存在，但突然有資格接受篩檢的 45 至 49 歲患者的湧入無疑加劇了這個問題。那麼您能談談這種動態是如何演變的嗎？這是否會為你帶來一次性的成長，但不是未來成長的持久驅動力？

And then second question, just a clarification. You talked about -- you've been telegraphing rescreen headwinds in the quarter. You'd also said some of the business you expected to fall in Q4 came in Q3. So can you just help us understand, help us quantify the headwinds and tailwinds in the quarter and what you see as sort of the base rate of sales?

然後是第二個問題，只是澄清一下。您談到—您一直在傳達本季重新篩選的不利因素。您還說過，您預計第四季會下降的一些業務在第三季出現了。那麼您能否幫助我們理解，幫助我們量化本季的逆風和順風以及您認為的基本銷售率？

Let me start with the capacity constraints around colonoscopies. You basically have very little growth in the number of gastroenterologists in the U.S. There's a fixed capacity for those residency programs. And what you saw was a significant number of retirements coming out of COVID. And so there is an overall flat or reduction in the total number of people scoping. What we're saying is about 6 million screening colonoscopies this year and next year, and as far as the eye can see, it's about -- that's about the capacity that we see now.

讓我從大腸鏡檢查的能力限制開始。美國胃腸病學家的數量基本上增長很少。這些住院醫師計畫的容量是固定的。你所看到的是，大量的人因新冠疫情而退休。因此，範圍界定的總人數整體持平或減少。我們所說的是，今年和明年大約有 600 萬次大腸鏡檢查，就眼睛所能看到的而言，這就是我們現在看到的容量。

But you added 19 million Americans who need to be screened and who -- that's in the 45- to 49-year-old age group. So it's a permanent shift in the way that these health systems are thinking about getting their patients screened and they're highly incentive and pushed to get their quality measures up. And one important quality measure is colon cancer screening. And so Everett, maybe you can touch it upon, again, the way that the commercial organization is addressing this important need.

但你又增加了 1900 萬需要接受篩檢的美國人，他們屬於 45 歲至 49 歲的年齡層。因此，這是這些衛生系統考慮對患者進行篩檢的方式的永久性轉變，並且他們非常積極地提高品質措施。一項重要的品質措施是大腸癌篩檢。埃弗里特，也許你可以再談談商業組織解決這個重要需求的方式。

Yes. And I love it when we say commercial because in addition to sales, having to be a focus of ours, we have a specific value proposition that we lay out to our customers around the 45- to 49-year-old. It's a different patient type. It's a patient type that they're busy parents, they're racing around dealing with kids. Cologuard is the perfect product for that 45- to 49-year-old. Plus, we know commercially when we get them, that 49- to 45- -- 45- to 49-year-old, we have them for multiple years moving forward. So that's one.

是的。我喜歡我們說商業，因為除了銷售之外，我們還必須將其作為我們的重點，我們還向 45 至 49 歲左右的客戶提出了特定的價值主張。這是一種不同的患者類型。這是一種耐心的類型，他們是忙碌的父母，他們忙著照顧孩子。 Cologuard 是 45 至 49 歲人群的完美產品。另外，我們在商業上知道，當我們得到他們時，49歲到45歲——45歲到49歲，我們會在未來的許多年裡擁有他們。這就是其中之一。

Marketing. We're marketing different to this cohort. It's important that we have a different marketing message that really like plays out the different lifestyles that 45- to 49-year-olds have. And our marketing mix is different. In addition to TV, we're finding out that they go through social media and digital more. So we've changed our mix more to market towards that cohort. So we're clearly explaining this to our health system customers. Our health system customers are coming to us because of the scenario that Kevin mentioned, and this will continue to be a growth lever for us this year and years to come.

行銷.我們的行銷方式與這群人不同。重要的是，我們需要傳達不同的行銷訊息，真正體現 45 至 49 歲人群的不同生活方式。我們的行銷組合是不同的。除了電視之外，我們發現他們還更多地瀏覽社交媒體和數位媒體。因此，我們更多地改變了我們的組合，以適應這群人的市場需求。因此，我們正在向我們的醫療系統客戶清楚地解釋這一點。由於凱文提到的情況，我們的醫療系統客戶來到我們這裡，這將繼續成為我們今年和未來幾年的成長槓桿。

There's 2 more parts to the question. This is Jeff. There's one on rescreens. The headwind that I talked about before, it's about $50 million for the year. If you think about that hitting second quarter, third quarter and fourth quarter. Third quarter gets a bit more than 1/3 of that and second and fourth get a bit less than 1/3, but it's fairly evenly spread. And the team did a very nice job working to offset, at least partially offset, the headwind during the quarter.

這個問題還有兩個部分。這是傑夫。有一部正在重映。我之前談到的逆風，今年大約是5000萬美元。如果你考慮一下第二季、第三季和第四季。第三季的比例略高於 1/3，第二季和第四季的比例略低於 1/3，但分佈相當均勻。團隊做得非常好，努力抵消（至少部分抵消）本季的不利因素。

You also see the care gap business, but this is a really small part of it. I had previously guided to somewhere just over $10 million in the whole second half for this business. It was more weighted towards Q4. That was the previous guidance. And what we found out during the quarter is that a bit more of that fell into Q3 than I previously expected. All told, it's a pretty small part of the business today. What really drove the quarter was the core underlying business that will sustain. It is a very durable leg of growth for us.

您還可以看到護理差距業務，但這只是其中的一小部分。我之前在整個下半年為這項業務引導了超過 1000 萬美元的資金。第四季的權重更大。這是之前的指導。我們在本季發現，第三季的投入比我之前的預期要多一些。總而言之，這只是當今業務的一小部分。真正推動本季發展的是核心基礎業務的持續發展。這對我們來說是一個非常持久的成長支柱。

We'll go next now to Alex Nowak at Craig-Hallum.

接下來我們將邀請 Craig-Hallum 的 Alex Nowak。

This is Albert [Hu] on for Alex. So after the FDA approval for the next-gen Cologuard, can you give us some rollout plans to physicians across the U.S. that you guys have as of right now? And we were also in the lab in June and what's the latest plan about the next-gen Cologuard and the vacant footprint for the lab? And how do you guys plan to convert the existing process over to the next-gen without running into any backlog issues?

我是阿爾伯特[胡]代表亞歷克斯。那麼，在 FDA 批准下一代 Cologuard 後，您能為我們提供一些目前向美國各地醫生推出的計劃嗎？ 6 月我們也在實驗室，關於下一代 Cologuard 的最新計劃以及實驗室的空置佔地面積是什麼？你們計劃如何將現有流程轉換為下一代流程而不遇到任何積壓問題？

Yes. Let me take the second part of that and hand the first part in terms of promoting and educating next-gen Cologuard to primary care docs. In terms of lab capacity, during that tour, you saw the additional 200,000 square feet of space that we have that is prepared for current and future product growth. So we have ample capacity at the 2 labs that we have today, coupled with automation that constantly is being implemented to increase to a capacity easily of 10 million tests per year.

是的。讓我談談第二部分，並將第一部分交給初級保健醫生推廣和教育下一代 Cologuard。就實驗室容量而言，在那次參觀中，您看到了我們額外擁有的 200,000 平方英尺的空間，為當前和未來的產品增長做好了準備。因此，我們今天擁有的 2 個實驗室擁有充足的能力，再加上不斷實施的自動化，可以輕鬆地將能力增加到每年 1000 萬次測試。

And switching over to Cologuard 2.0, we have plenty of space -- physical space here in Madison, Wisconsin, to be able to meet that need. We have a very thoughtful plan from top to bottom about how that is going to happen and our team over the last 10 years, I'm very proud to say our operations team, our lab team have never missed. We've never had a day, a week, a month that we couldn't generate Cologuard results. This is an amazing team of professionals, automation experts, scientists, laboratorians who will make this a smooth changeover.

切換到 Cologuard 2.0 後，我們有足夠的空間（位於威斯康辛州麥迪遜市的實體空間）來滿足這一需求。我們從上到下有一個非常周到的計劃，關於如何實現這一目標，我們的團隊在過去 10 年裡，我非常自豪地說，我們的營運團隊、我們的實驗室團隊從未錯過。我們從來沒有一天、一週、一個月無法產生 Cologuard 結果。這是一支由專業人士、自動化專家、科學家、實驗室人員組成的令人驚嘆的團隊，他們將使這一轉變順利進行。

In terms of getting Cologuard ready for the next kind of year, what we're going to do -- I look at it 2 ways. First of all, we have a year to get ready, but the most important thing that we can do commercially is sell Cologuard and focus on making sure that we get those providers that are writing it to write more, and those providers that are not writing it to start writing Cologuard.

就讓 Cologuard 為明年做好準備而言，我們將要做的事情 - 我從兩個方面來看。首先，我們有一年的時間來準備，但我們在商業上可以做的最重要的事情是出售Cologuard 並專注於確保我們讓那些正在編寫它的提供者編寫更多內容，以及那些沒有編寫它的提供商開始編寫 Cologuard。

What we like about the next-generation Cologuard is there's 30% fewer false positive. And we know those physicians, for whatever reason, it is a major roadblock for them. They stay away from Cologuard because of the false positives. We know exactly who those physicians are, and that will be our first kind of low-hanging fruit is to go to those physicians and talk about the next-generation Cologuard and get them excited.

我們喜歡下一代 Cologuard 的一點是誤報率降低了 30%。我們知道那些醫生，無論出於何種原因，這對他們來說都是一個主要障礙。由於誤報，他們遠離 Cologuard。我們確切地知道這些醫生是誰，這將是我們第一個容易實現的目標，那就是去找這些醫生談論下一代 Cologuard 並讓他們興奮。

What I like about the next generation Cologuard is internally, our entire company is excited about this. And so we're going to use that excitement, that excitement in the field to increase, again, the people that are writing Cologuard

我喜歡下一代 Cologuard 的原因是在內部，我們整個公司都對此感到興奮。因此，我們將利用這種興奮感，那種在該領域的興奮感來再次增加編寫 Cologuard 的人們

Thank you. And that does conclude our question-and-answer session for this afternoon, ladies and gentlemen, and it will bring us to the close of the call. We'd like to thank you all so much for joining the Exact Sciences Third Quarter 2023 Earnings Call. Again, thank you for joining, and have a great afternoon. Goodbye.

謝謝。女士們，先生們，今天下午的問答環節就到此結束了，我們的電話會議也將結束。我們非常感謝大家參加 Exact Sciences 2023 年第三季財報電話會議。再次感謝您的加入，祝您下午愉快。再見。