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⚠ A Screening Business Set by Guideline WritersModerate threat

Abbott Laboratories (ABT) — threat to the moat

Exact Sciences sold 96.9% of its 2025 output in the United States, so Abbott's new cancer business rests on one country's guidelines.

Cologuard's strength is also its exposure. Its demand rests on screening guidelines and on payers covering the test, and in May 2026 the American Cancer Society reaffirmed it as a preferred option for adults aged 45 and over1. Guidelines can change, and a new type of test can be added beside it.

Exact Sciences sales by region, 2025 ($M)3,145United States102InternationalAbbott Q2 2026 earnings release, footnote on Exact Sciences 2025 sales
Almost all of it American.

Concentration makes that matter more. Exact's 2025 sales were $3.247 billion, $3.145 billion of them in the United States2. Abbott's other businesses sell 61% of their output outside the US3; this one is a bet on one country's screening policy.

Abbott also took on the cost of the bet. Its estimated amortization of intangible assets is about $2.6 billion in 20264, up from $1,682 million in 20255, largely because of the $12.8 billion of intangible assets recorded for Exact6.

Abbott is already selling against the risk. It said Cologuard's growth benefited from "a growing base of both new and repeat users"7, which is how a screening test becomes a habit before a rival test is recommended beside it.

The balance sheet already carries the bet. Diagnostics goodwill was $15.0 billion at 30 June 20268, most of it added by Exact, and a change in screening guidelines is exactly the kind of event that leads to an impairment test.

The falsifier is a guideline. The reason Abbott paid 6.3 times sales weakens the day a guideline ranks another test ahead of Cologuard, or the first quarter Cancer Diagnostics growth falls below the high single digits.

References
  1. ReportedIts demand rests on screening guidelines and on payers covering the test, and in May 2026 the American Cancer Society reaffirmed it as a preferred option for adults aged 45 and over.
    Abbott Laboratories second-quarter 2026 earnings release, Form 8-K exhibit 99.1 - sales by segment and business, comparable growth, income statement, specified items, guidance and the 410th consecutive quarterly dividend - Diagnostics sales by business, Cancer Diagnostics and Cologuard. — Q2 2026 · publ. 16 July 2026 · source ↗
  2. ReportedExact's 2025 sales were $3.247 billion, $3.145 billion of them in the United States.
    Abbott Laboratories second-quarter 2026 earnings release, Form 8-K exhibit 99.1 - sales by segment and business, comparable growth, income statement, specified items, guidance and the 410th consecutive quarterly dividend - Diagnostics sales by business, Cancer Diagnostics and Cologuard. — Q2 2026 · publ. 16 July 2026 · source ↗
  3. ReportedAbbott's other businesses sell 61% of their output outside the US; this one is a bet on one country's screening policy.
    Abbott Laboratories Form 10-K for 2025 (year ended 31 December 2025) - Item 1 business and the segment note: the four segments, sales and operating earnings, employees, manufacturing sites, customers and geography. — FY2025 · publ. 20 February 2026 · source ↗
  4. ReportedIts estimated amortization of intangible assets is about $2.6 billion in 2026, up from $1,682 million in 2025, largely because of the $12.8 billion of intangible assets recorded for Exact.
    Abbott Laboratories Form 10-Q for the quarter ended 30 June 2026 - segment sales and operating earnings, the Exact Sciences acquisition and purchase-price allocation, the $20.0 billion of notes, remaining performance obligations, goodwill by segment, expected amortization, legal reserves and the NEC litigation, and the balance sheet at 30 June 2026 - the Exact Sciences acquisition, purchase-price allocation, goodwill by segment and expected amortization. — Q2 2026 · publ. 28 July 2026 · source ↗
  5. ReportedIts estimated amortization of intangible assets is about $2.6 billion in 2026, up from $1,682 million in 2025, largely because of the $12.8 billion of intangible assets recorded for Exact.
    Abbott Laboratories Form 10-K for 2025 (year ended 31 December 2025) - consolidated financial statements: income, taxes, cash flow, dividends, repurchases, debt, goodwill and the critical accounting policy on rebates. — FY2025 · publ. 20 February 2026 · source ↗
  6. ReportedIts estimated amortization of intangible assets is about $2.6 billion in 2026, up from $1,682 million in 2025, largely because of the $12.8 billion of intangible assets recorded for Exact.
    Abbott Laboratories Form 10-Q for the quarter ended 30 June 2026 - segment sales and operating earnings, the Exact Sciences acquisition and purchase-price allocation, the $20.0 billion of notes, remaining performance obligations, goodwill by segment, expected amortization, legal reserves and the NEC litigation, and the balance sheet at 30 June 2026 - the Exact Sciences acquisition, purchase-price allocation, goodwill by segment and expected amortization. — Q2 2026 · publ. 28 July 2026 · source ↗
  7. ReportedIt said Cologuard's growth benefited from "a growing base of both new and repeat users", which is how a screening test becomes a habit before a rival test is recommended beside it.
    Abbott Laboratories second-quarter 2026 earnings release, Form 8-K exhibit 99.1 - sales by segment and business, comparable growth, income statement, specified items, guidance and the 410th consecutive quarterly dividend - Diagnostics sales by business, Cancer Diagnostics and Cologuard. — Q2 2026 · publ. 16 July 2026 · source ↗
  8. ReportedDiagnostics goodwill was $15.0 billion at 30 June 2026, most of it added by Exact, and a change in screening guidelines is exactly the kind of event that leads to an impairment test.
    Abbott Laboratories Form 10-Q for the quarter ended 30 June 2026 - segment sales and operating earnings, the Exact Sciences acquisition and purchase-price allocation, the $20.0 billion of notes, remaining performance obligations, goodwill by segment, expected amortization, legal reserves and the NEC litigation, and the balance sheet at 30 June 2026 - the Exact Sciences acquisition, purchase-price allocation, goodwill by segment and expected amortization. — Q2 2026 · publ. 28 July 2026 · source ↗
Sources
Generated October 6, 2026