Cancer Molecular Diagnostics Markets 2027–2031

Cancer Molecular Diagnostics Markets: Market Forecast, Competitive Landscape, Technology and Partnering Opportunities, 2027–2031 (October 2026)

Global forecasts by cancer type, application, technology, product and customer, for 14 countries and regions, with 96 company profiles.

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Our Take

Cancer molecular diagnostics are moving from one test at diagnosis to repeated testing across the patient journey. The market grows from $10.56 billion in 2026 to $18.5 billion in 2031, at 11.9% a year. Blood-based screening at the start of the journey and MRD monitoring at the end take nearly half of the new spending, and sequencing takes over from PCR.

Market Size 2026: USD $10.56B Market Size 2031: USD $18.5B CAGR: 11.9%

Situation Analysis: what is really happening

• Screening and monitoring lead. MRD & Monitoring is the fastest-growing application, at 20.6% a year from $1,162 million to $2,960 million. Screening & Early Detection grows 13.5% a year to $4,070 million. Together they take 47% of new spending.
• Sequencing takes over. NGS grows 16.3% a year from $4,171 million to $8,880 million, rising from 39.5% to 48.0% of the market and taking 59% of new spending. PCR & Digital PCR grows only 7.8% a year.
• Blood joins stool in colorectal screening. The FDA approved Freenome's SimpleScreen CRC, the American Cancer Society added blood tests to its guideline and UnitedHealth began covering Shield. Congress gave Medicare a coverage pathway for multi-cancer early detection tests.
• Germline testing becomes universal. NCCN now recommends germline panel testing for all colorectal, endometrial and gastric cancer patients, and home collection for HPV testing arrived with Onclarity.
• Services grow faster than kits. Software & Services grow 16.0% a year to $6,660 million and take 44% of growth. Clinical Laboratories reach 74.5% of the market in 2031.
• Prostate and China grow fastest. Lung is the largest cancer type at $2,376 million, but prostate cancer testing grows 15.2% a year. China grows 14.3% a year from $925 million to $1,804 million, while the USA holds 43.3% of the market.

Company Analysis: who is positioned, who is exposed

• Abbott (Exact Sciences): Completed its $21 billion acquisition of Exact Sciences in March 2026, adding Cologuard, Oncotype DX, Oncodetect and Cancerguard, and is launching Freenome's SimpleScreen CRC in the U.S.
• Guardant Health: Shield blood screening gained UnitedHealth coverage and ACS guideline support, and the next-generation Guardant360 Liquid CDx was approved in May 2026.
• GRAIL: An FDA advisory panel voted in favour of the Galleri multi-cancer test, with Medicare now able to cover approved multi-cancer tests.
• Natera and Myriad Genetics: Signatera CDx became the first MRD companion diagnostic, and Myriad expanded Precise MRD to breast, colorectal and kidney cancer.
• Illumina and Thermo Fisher Scientific: TruSight Oncology Comprehensive gained a national Medicare rate and Oncomine Dx Express brings 24-hour profiling into hospital laboratories.
• Roche, Hologic and Waters: Lead HPV and PCR testing, a mature base growing slower as sequencing takes share; Hologic was taken private and Waters now owns BD's Onclarity.

Plus 86 more company profiles, each one to two pages with a fact box covering website, headquarters, ownership, revenue, employees and key products.

Questions this report answers

• How fast will blood-based colorectal and multi-cancer screening grow, and what will Medicare coverage mean?
• How large can MRD and monitoring become as tumour-informed tests spread across cancers?
• How quickly will NGS take share from PCR, ISH/FISH and microarrays?
• Which cancers, applications and customers will add the most new spending?
• Who are the leading companies and partners, and what are cancer diagnostics companies selling for?
• How large is each country market, and how fast is China growing?

What's inside

• 411 pages, 24 chapters, 61 tables and 53 figures
• Forecasts for 2027–2031 from a 2026 base year, by cancer type, application, technology, product and customer, for 14 countries and regions
• Approved test landscape, clinical evidence and test pipeline, technology landscape, pricing and business models
• Regulation and reimbursement, a China chapter, a deal database and laboratory operations
• 10 market-moving developments from 2025 and 2026, SWOT and strategic recommendations
• 96 company profiles
• Download the Table of Contents (PDF)

Who buys this report

• Diagnostics executives and business development teams: size cancer testing opportunities by application and technology and find partners and acquisition targets.
• Laboratory directors: plan capacity for screening, germline, profiling and MRD testing, and decide what to run in house.
• Investors and analysts: model the growth of blood-based screening, MRD and sequencing and benchmark deal values.
• Instrument and reagent suppliers: judge demand for sequencing, PCR, ISH and software in clinical, pharma and research laboratories.

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ABOUT THE LEAD AUTHOR

Mr. Greg Powell, B.Sc., M.B.A., is the President of Howe Sound Research. His education includes:

Finance for Senior Executives - Harvard Business School

Market Research - Burke Institute

M.B.A. (Finance and Policy) - University of British Columbia

B.Sc. (Chemistry) - University of British Columbia

He is an experienced business and clinical professional. He is co-author of the paper "The Radioimmunoassay of Angiotensinogen by Antibody Trapping." He has worked in laboratory testing and management for over 20 years.