Guardant Health's Shield has the edge over Freenome in colorectal screening. The data are the same, but Guardant gives patients a free option to screen for other cancers and has better coverage, making it more seamless. Freenome was supposed to differentiate on advanced adenoma detection, but its results were mediocre. x.com 

BillionToOne is taking share in both prenatal testing and oncology thanks to patented technology that makes its tests more sensitive and specific. It is the only diagnostic peer that is GAAP profitable, and it may be best positioned to offer a genuinely useful early cancer detection test, adding optionality. On revenue it looks pricier, but its real comparables, Natera and Guardant Health, are about 50% more expensive while growing more slowly and earning less. x.com  x.com 

Guardant Health still looks overvalued because its Shield screening economics are not proven at scale. Management's own 2028 guidance of about $2.2 billion revenue has not been raised, and Shield's unit economics remain weak, with high COGS and dilution at current volumes. Even on @somebakedziti's upside case of $2.8 billion revenue and a 25x multiple, the 2028 price is in the mid-$90s, worth about $65-78 today. Better reimbursement does not change current unit economics or valuation. x.com 

Tempus AI's diagnostics-to-data-to-AI flywheel makes its roughly 7.2x forward sales interesting, about half Natera's and Guardant's 16x, though both grow faster. Q2 revenue rose 22% to $382.5M, Data Licensing & Modeling grew 36%, and 2026 guidance is about $1.6B of revenue and $65M of adjusted EBITDA. As a ~25% growth diagnostics company, ~7x may be reasonable; if growth reaccelerates toward 30%+, Data + Applications grows much larger and margins expand, the valuation could look very different. … Show more

BillionToOne should keep taking share from Natera because its products' efficacy is far ahead, and it has a good chance of becoming a $100B-plus company. Few companies grow this fast with such an intriguing business model while already profitable. A share price above $100 does not make it expensive, since it has fewer than 50M shares outstanding and price per share says nothing about size or upside. x.com  x.com  x.com 

Natera is the best short in diagnostics because its valuation demands accelerating KPIs that are likely to slow. Signatera is great, but growth should decelerate, while the legacy women's health business is highly penetrated and facing competition from BillionToOne. Opex should rise next year more than the buy side expects, and the stock is crowded with tourists. Even 25% sales growth for a decade with 25% EBITDA margins yields only about $250 a share on a DCF. x.com  x.com  x.com  x.com  x.com 

NeoGenomics is firing on all cylinders at new all-time highs after a power gap on its recent earnings, in the strong genetic-testing corner of medical devices. It carries a rare A+ accumulation grade and a 97 relative-strength rating, and surfaced on a 'Power PEG' screen. x.com