olivLaw · US equity research
Castle Biosciences, Inc. CSTL
Services-Medical Laboratories · SIC 8071 · Vertical: Services-Medical Laboratories (SIC 8071)
Castle Biosciences is a molecular diagnostics company offering genetic tests for dermatologic cancers, Barrett's esophagus, atopic dermatitis and uveal melanoma. Revenue grew in the first half of 2026 and full-year guidance was raised, which keeps the performance of TissueCypher and DecisionDx-Melanoma in focus. The company remains dependent on Medicare reimbursement and still reports historical accounting losses.
At the close of 04 Nov 2026, Castle Biosciences, Inc. (CSTL) stock was 35.75 USD (+1.74% on the day), with market capitalisation 1.1 bn USD, dividend yield 0.00%, beta 0.85, 52-week range 18.15–43.04 USD. Latest reported quarter (Q2 2026): revenue of 103.5 m USD (+20.1% YoY), net income of -2.1 m USD (−145.5% YoY), diluted EPS -0.07 USD.
Data as of · AI analysis dated · Source: SEC filings and closing prices, computed by olivLaw.
Price history
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Technical reading
- RSI (14)
- 54.5
- neutral
- Bollinger (20, 2)
- 30.80 – 37.58
- in the upper half of the band · %B 0.73 · band width 19.8%
- SMA 50 / 200
- 34.31 / 28.48
- uptrend (price > SMA50 > SMA200)
- MACD (12, 26, 9)
- 0.58 / 0.39
- MACD above signal
Indicators describe past prices; on their own they do not predict direction. On our history the RSI ≤ 40 filter added no return (see the signals methodology).
Performance
| Company | S&P 500 | vs S&P 500 | Vertical median | |
|---|---|---|---|---|
| 1 month | −2.5% | −1.1% | −1.4 pp | — |
| 3 months | +17.6% | −0.5% | +18.1 pp | — |
| 6 months | +44.4% | +4.4% | +40.1 pp | — |
| Year to date | −8.1% | +12.3% | −20.4 pp | — |
| 1 year | +13.0% | +13.5% | −0.5 pp | +7.7% |
| 3 years | +98.8% | +76.4% | +22.4 pp | +62.1% |
| 5 years | −40.0% | +63.7% | −103.6 pp | — |
Price returns, dividends excluded.
Quarterly results
Latest quarter: Q2 2026 · 30 Jun 2026
Quarterly margins
Quarterly statements · USD
| Fiscal year | Q3 '24 | Q4 '24 | Q1 '25 | Q2 '25 | Q3 '25 | Q4 '25 | Q1 '26 | Q2 '26 |
|---|---|---|---|---|---|---|---|---|
| Revenue | 85.8 m | 86.3 m | 88.0 m | 86.2 m | 83.0 m | 87.0 m | 83.7 m | 103.5 m |
| Cost of revenue | 15.6 m | 16.2 m | 16.4 m | 17.6 m | 18.7 m | 18.3 m | 20.5 m | 23.7 m |
| Research & development | 12.3 m | 11.8 m | 12.6 m | 12.8 m | 13.0 m | 13.5 m | 14.4 m | 14.5 m |
| SG&A | 50.5 m | 50.0 m | 58.6 m | 58.1 m | 55.9 m | 56.7 m | 64.9 m | 66.1 m |
| Operating income | 5.1 m | 4.1 m | -27.9 m | -4.3 m | -6.8 m | -3.8 m | -18.4 m | -3.1 m |
| Depreciation & amortisation | 3.5 m ≈ | 5.8 m | 29.8 m | 3.4 m ≈ | 3.8 m ≈ | 3.8 m | 3.9 m | 4.1 m ≈ |
| Interest expense | 192.0 k | 156.0 k | 8.0 k | 9.0 k | 24.0 k | 24.0 k | 134.0 k | 193.0 k |
| Income tax | 6.0 m | -1.7 m | -423.0 k | -4.7 m | 115.0 k | -382.0 k | 109.0 k | 370.0 k |
| Net income | 2.3 m | 9.6 m | -25.8 m | 4.5 m | -501.0 k | -2.3 m | -14.5 m | -2.1 m |
| Diluted EPS | 0.08 | 0.31 ≈ | -0.90 | 0.15 | -0.02 | -0.08 ≈ | -0.49 | -0.07 |
| Operating cash flow | 23.3 m ≈ | 24.4 m | -6.0 m | 20.8 m ≈ | 22.6 m ≈ | 26.9 m | -22.1 m | 15.2 m ≈ |
| Capex | 6.4 m ≈ | 7.6 m | 4.7 m | 9.3 m ≈ | 14.8 m ≈ | 7.2 m | 12.5 m | 8.7 m ≈ |
≈ derived quarter (cumulative difference / share-days average)
E/P over time
E/P = trailing-12-month diluted EPS / price at quarter end. E/P is the inverse of P/E and stays defined when earnings are negative.
Fiscal years
| Fiscal year | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 |
|---|---|---|---|---|---|---|---|---|
| Revenue | 22.8 m | 51.9 m | 62.6 m | 94.1 m | 137.0 m | 219.8 m | 332.1 m | 344.2 m |
| Revenue YoY | unavailable | +127.6% | +20.8% | +50.2% | +45.7% | +60.4% | +51.1% | +3.7% |
| Net income | -6.4 m | 5.3 m | -10.3 m | -31.3 m | -67.1 m | -57.5 m | 18.2 m | -24.2 m |
| Net income YoY | unavailable | unavailable | −294.9% | unavailable | unavailable | unavailable | unavailable | −232.4% |
| Diluted EPS | -5.33 | -0.21 | -0.54 | -1.24 | -2.58 | -2.14 | 0.62 | -0.83 |
| Diluted EPS YoY | unavailable | unavailable | unavailable | unavailable | unavailable | unavailable | unavailable | −233.9% |
| net % | -27.9% | 10.2% | -16.4% | -33.3% | -49.0% | -26.1% | 5.5% | -7.0% |
| Free cash flow | -12.6 m | 6.1 m | 5.1 m | -22.5 m | -47.3 m | -19.2 m | 36.5 m | 28.3 m |
Reported results vs expectations
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Balance sheet & financial health
Fiscal year 2025 · 31 Dec 2025
- Cash
- 116.7 m USD
- Financial debt
- 10.1 m USD
- Net debt
- -106.7 m USD
- Equity
- 470.9 m USD
- Total assets
- 578.6 m USD
- Debt / equity
- 0.02x
- Current ratio
- 5.26x
- ROE
- -5.2%
- ROA
- -4.4%
- FCF margin
- 8.2%
Financial statements (source on every figure)
Revenue and net income (USD)
Margins
Income statement · USD
| Line | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | Source (latest year) |
|---|---|---|---|---|---|---|---|
| Revenue | 62.6 m | 94.1 m | 137.0 m | 219.8 m | 332.1 m | 344.2 m | SEC (XBRL)· 26 Feb 2026verified |
| Cost of revenue | 9.7 m | 15.8 m | 32.0 m | 45.0 m | 60.2 m | 71.0 m | SEC (XBRL)· 26 Feb 2026verified |
| Gross profit | 53.0 m | 78.3 m ≈ | 105.0 m ≈ | 174.8 m ≈ | 271.9 m ≈ | 273.2 m ≈ | SEC (XBRL)· 26 Feb 2026derived |
| Research & development | 13.3 m | 29.6 m | 44.9 m | 53.6 m | 52.0 m | 51.9 m | SEC (XBRL)· 26 Feb 2026verified |
| SG&A | 48.1 m | 86.7 m | 143.0 m | 180.2 m | 200.0 m | 229.3 m | SEC (XBRL)· 26 Feb 2026verified |
| Operating income | -6.5 m | -40.1 m | -72.9 m | -68.0 m | 8.7 m | -42.8 m | SEC (XBRL)· 26 Feb 2026verified |
| Depreciation & amortisation | 472.0 k | 3.4 m | 10.5 m | 12.3 m | 16.0 m | 40.8 m | SEC (XBRL)· 26 Feb 2026verified |
| EBITDA | -6.1 m ≈ | -36.7 m ≈ | -62.3 m ≈ | -55.6 m ≈ | 24.7 m ≈ | -2.0 m ≈ | SEC (XBRL)· 26 Feb 2026derived |
| Interest expense | 2.6 m | 1.0 k | 17.0 k | 11.0 k | 577.0 k | 86.0 k | SEC (XBRL)· 26 Feb 2026verified |
| Income tax | 84.0 k | -8.7 m | -1.8 m | 101.0 k | 3.3 m | -5.4 m | SEC (XBRL)· 26 Feb 2026verified |
| Net income | -10.3 m | -31.3 m | -67.1 m | -57.5 m | 18.2 m | -24.2 m | SEC (XBRL)· 26 Feb 2026verified |
| Diluted EPS | -0.54 | -1.24 | -2.58 | -2.14 | 0.62 | -0.83 | SEC (XBRL)· 26 Feb 2026verified |
| Weighted average diluted shares | 18.9 m | 25.1 m | 26.1 m | 26.8 m | 29.3 m | 29.0 m | SEC (XBRL)· 26 Feb 2026verified |
| Dividend per share | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | SEC (XBRL)· 26 Feb 2026verified |
≈ computed by olivLaw from the reported lines of the same year: Revenue − Cost of revenue; Operating income + Depreciation & amortisation.
Balance sheet · USD
| Line | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | Source (latest year) |
|---|---|---|---|---|---|---|---|
| Cash | 409.9 m | 329.6 m | 122.9 m | 98.8 m | 119.7 m | 116.7 m | SEC (XBRL)· 26 Feb 2026verified |
| Receivables | 12.8 m | 17.3 m | 23.5 m | 38.3 m | 51.2 m | 43.4 m | SEC (XBRL)· 26 Feb 2026verified |
| Inventories | 2.2 m | 2.0 m | 4.0 m | 7.9 m | 8.1 m | 10.3 m | SEC (XBRL)· 26 Feb 2026verified |
| Current assets | 429.6 m | 353.7 m | 292.3 m | 295.6 m | 360.2 m | 361.1 m | SEC (XBRL)· 26 Feb 2026verified |
| Property, plant & equipment, net | 7.1 m | 9.5 m | 14.3 m | — | — | — | SEC (XBRL)· 28 Feb 2023verified |
| Goodwill | — | 0 | 10.7 m | 10.7 m | 10.7 m | 10.7 m | SEC (XBRL)· 26 Feb 2026verified |
| Intangibles (excl. goodwill) | 0 | 88.9 m | 115.7 m | 106.6 m | 95.5 m | 88.9 m | SEC (XBRL)· 26 Feb 2026verified |
| Total assets | 439.3 m | 462.6 m | 447.3 m | 453.3 m | 531.2 m | 578.6 m | SEC (XBRL)· 26 Feb 2026verified |
| Accounts payable | 2.1 m | 2.5 m | 4.7 m | 10.3 m | 6.9 m | 18.7 m | SEC (XBRL)· 26 Feb 2026verified |
| Short-term debt | 0 | — | — | 0 | 278.0 k | 417.0 k | SEC (XBRL)· 26 Feb 2026verified |
| Long-term debt | 0 | — | — | 0 | 9.7 m | 9.6 m | SEC (XBRL)· 26 Feb 2026verified |
| Current liabilities | 20.9 m | 24.9 m | 36.1 m | 47.7 m | 49.4 m | 68.7 m | SEC (XBRL)· 26 Feb 2026verified |
| Total liabilities | 23.6 m | 50.8 m | 48.2 m | 62.1 m | 75.4 m | 107.7 m | SEC (XBRL)· 26 Feb 2026verified |
| Equity | 415.7 m † | 411.7 m † | 399.2 m † | 391.3 m † | 455.8 m † | 470.9 m † | SEC (XBRL)· 26 Feb 2026verified |
† equity attributable to the parent's shareholders: in these years the issuer no longer reports the total including non-controlling interests.
Cash flow · USD
| Line | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | Source (latest year) |
|---|---|---|---|---|---|---|---|
| Operating cash flow | 9.9 m | -19.0 m | -41.7 m | -5.6 m | 64.9 m | 64.3 m | SEC (XBRL)· 26 Feb 2026verified |
| Capex | 4.8 m | 3.5 m | 5.6 m | 13.6 m | 28.3 m | 36.0 m | SEC (XBRL)· 26 Feb 2026verified |
| Free cash flow | 5.1 m ≈ | -22.5 m ≈ | -47.3 m ≈ | -19.2 m ≈ | 36.5 m ≈ | 28.3 m ≈ | SEC (XBRL)· 26 Feb 2026derived |
| Investing cash flow | -4.7 m | -66.7 m | -166.5 m | -16.2 m | -50.1 m | -60.4 m | SEC (XBRL)· 26 Feb 2026verified |
| Financing cash flow | 305.9 m | 5.4 m | 1.5 m | -2.3 m | 6.1 m | -7.0 m | SEC (XBRL)· 26 Feb 2026verified |
≈ computed by olivLaw from the reported lines of the same year: Operating cash flow − Capex.
Computed indicators
Growth
Profitability
Returns
Balance sheet
Liquidity
Cash
Efficiency
Market and valuation
1 indicators that do not apply to the sector.
Valuation
olivLaw classification
- score weight coverage: 43.8% of at least 60%
- valuation methods computed: 0 of at least 1
A scoring methodology on indicators and valuation, not investment advice.
Closing price
04 Nov 2026Source: olivLaw, closing series
Market cap: 1.1 bn USD
Key indicators
Coverage and freshness
Score by group
44% · Insufficient data
Estimated value range
unavailable — no valuation method could be computed
Valuation assumptions are editorial choices, not measured; beta is not measured.
Valuation methods
- DCF (discounted cash flow)unavailable · the base of the ratio is not positive
- Peers: EV/EBITDAunavailable · the base of the ratio is not positive
- Peers: P/Eunavailable · the base of the ratio is not positive
- Dividend discount (DDM)unavailable · the base of the ratio is not positive
no valuation method could be computed
Classification (SIC) comparables group by industry code, not by economic activity; the direct group is an editorial selection by activity. Members' multiples are on their own trailing twelve months, at their own latest close.
Assumptions (illustrative, editorial)
- Risk-free rate
- 4.3%
- Equity risk premium
- 5.0%
- Beta (default)
- 1.00
- Cost of equity
- 9.3%
- Terminal growth
- 2.5%
Factor scorecard
Insufficient data
Minimum-evidence gate: score weight coverage: 43.8% of at least 60%; valuation methods computed: 0 of at least 1
| Factor | Value | Score | Weight used |
|---|---|---|---|
| ROIC · Quality | -6.7% | 50 (vs peers) | 24% |
| Net margin · Quality | -5.4% | 61 (vs peers) | 14% |
| FCF conversion · Quality | unavailable | unavailable | — |
| Revenue CAGR 3Y · Growth | 35.9% | 100 (on a fixed band) | 19% |
| EPS CAGR 3Y · Growth | unavailable | unavailable | — |
| Net debt / EBITDA · Balance sheet | unavailable | unavailable | — |
| Interest coverage · Balance sheet | -85.6x | 0 (on a fixed band) | 14% |
| Current ratio · Balance sheet | 6.0x | 100 (on a fixed band) | 10% |
| P/E (TTM) · Valuation | unavailable | unavailable | — |
| EV/EBITDA · Valuation | unavailable | unavailable | — |
| FCF yield · Valuation | -0.0% | 0 (on a fixed band) | 19% |
| Shareholder yield (distributions) · Returns | unavailable | unavailable | — |
| Payout ratio (FCF) · Returns | unavailable | unavailable | — |
Factors without a value were dropped; the remaining weights were renormalised.
Score groups
- Balance sheet40/100 · 2/3 factors with a value
- Growth· partial100/100 · 1/2 factors with a value
- Quality54/100 · 2/3 factors with a value
- Returns· partialunavailable · 0/2 factors with a value
- Valuation· partial0/100 · 1/3 factors with a value
A «partial» group is computed from under half of its weight or from one factor: it is not a full assessment of the group.
Memo
CASTLE BIOSCIENCES, INC. (CSTL). Latest full fiscal year: 2025; data up to 2026-06-30.
Figures computed from the financial statements: revenue 344.2 m USD in 2025; YoY growth 3.7%; net margin -5.4%; ROE -4.2%.
Valuation cannot be computed from the available data.
Insufficient data for a verdict (score weight coverage: 43.8% of at least 60%; valuation methods computed: 0 of at least 1).
Text generated deterministically from the figures shown; no language model. Not investment advice.
What supports the thesis
- Revenue CAGR 3Y: 35.9%
- Current ratio: 6.0x
What contradicts it
- Interest coverage: -85.6x
- FCF yield: -0.0%
Not assessed (insufficient data or a ratio without meaning): FCF conversion, EPS CAGR 3Y, Net debt / EBITDA, P/E (TTM), EV/EBITDA, Shareholder yield (distributions), Payout ratio (FCF).
Versus the vertical median
Services-Medical Laboratories (SIC 8071) · same industry (4-digit SIC) · compared with 23 companies
Multiples and returns vs the median
Price rebased to 100 (monthly, 5 years)
Companies in the vertical
| Market cap | P/E | ROE | Net margin | Revenue YoY | 1A / 3A | |
|---|---|---|---|---|---|---|
| NTRANatera, Inc. | 56.4 bn | — | -12.5% | -7.1% | +35.9% | +64% / +599% |
| LHLabcorp Holdings Inc. | 29.9 bn | 30.2 | 11.4% | 6.9% | +7.2% | +37% / +70% |
| DGXQuest Diagnostics Inc | 28.1 bn | 25.5 | 15.2% | 9.5% | +11.8% | +35% / +86% |
| GHGuardant Health, Inc. | 22.6 bn | — | — | -38.3% | +32.9% | +55% / +570% |
| CAICaris Life Sciences, Inc. | 9.5 bn | 97.6 | 17.2% | 9.2% | +97.0% | +30% / unavailable |
| GRALGRAIL, Inc. | 6.4 bn | — | -16.1% | -236.9% | +17.2% | +30% / unavailable |
| RDNTRadNet, Inc. | 6.3 bn | — | -2.1% | -0.9% | +11.5% | −3% / +142% |
| CDNACaredx, Inc. | 4.5 bn | 35.9 | 33.0% | 25.9% | +13.8% | +380% / +784% |
| VCYTVeracyte, Inc. | 4.2 bn | 37.5 | 8.8% | 20.4% | +16.0% | +11% / +105% |
| FTREFortrea Holdings Inc. | 2.0 bn | — | -12.3% | -2.6% | +1.0% | +64% / −29% |
| PSNLPersonalis, Inc. | 1.7 bn | — | -62.1% | -147.7% | −17.7% | +47% / +932% |
| BLLNBillionToOne, Inc. | 1.3 bn | 118.4 | 30.2% | 11.3% | +100.0% | −13% / unavailable |
| CSTLCastle Biosciences, Inc. | 1.1 bn | — | -4.2% | -5.4% | +3.7% | +13% / +99% |
| FLGTFulgent Genetics, Inc. | 541.5 m | — | -8.0% | -26.0% | +13.8% | −33% / −29% |
| YDESYD Bio Limited | 492.0 m | — | -445.1% | -1,392.6% | +16.9% | −40% / unavailable |
| BDSXBiodesix, Inc. | 226.7 m | — | -540.0% | -27.0% | +24.1% | +160% / −28% |
| XGNExagen Inc. | 206.2 m | — | -113.8% | -26.6% | +19.7% | +8% / +363% |
| SERASera Prognostics, Inc. | 59.0 m | — | -49.7% | -34,866.7% | +5.2% | −39% / +4% |
| AMSAmerican Shared Hospital Services | 8.2 m | — | -7.5% | -5.8% | −0.9% | −43% / −48% |
| MDXHMdxhealth SA | 8.0 m | — | -2,440.4% | -31.1% | +19.8% | −96% / −95% |
| ACONAclarion, Inc. | 5.0 m | — | -59.0% | -10,978.5% | +65.6% | −72% / −100% |
| ADVBAdvanced Biomed Inc. | 3.5 m | 0.4 | 84.8% | 5,231.3% | unavailable | −75% / unavailable |
| BGLCBioNexus Gene Lab Corp. | 2.8 m | — | -33.7% | -82.4% | −21.9% | −79% / −90% |
| BNRBurning Rock Biotech Limited | 0 | — | -10.1% | -10.3% | +9.2% | −41% / +55% |
1- and 3-year price returns: for CSTL from daily closes (the same as the performance table), for the other companies from month-end closes.
olivLaw engine forecast
The world engine ran after the company's latest material disclosure. Probabilities are of TOUCHING a level within the horizon (not closing there) and sit next to the random walk (p_rw), the no-information benchmark.
The engine has no published run for this company yet.
Valuation scenarios (editable assumptions)
Illustrative scenarios
Illustrative: not forecasts and without probabilities. Each case is one coherent set of assumptions, computed on today's figures.
Estimated price (USD)
| Estimated price | Bear | Base | Bull |
|---|---|---|---|
| 1 years | insufficient data Total return unavailable · Per year unavailable | insufficient data Total return unavailable · Per year unavailable | insufficient data Total return unavailable · Per year unavailable |
| 3 years | insufficient data Total return unavailable · Per year unavailable | insufficient data Total return unavailable · Per year unavailable | insufficient data Total return unavailable · Per year unavailable |
| 5 years | insufficient data Total return unavailable · Per year unavailable | insufficient data Total return unavailable · Per year unavailable | insufficient data Total return unavailable · Per year unavailable |
AI analysis
AI-generatedAI-generated analysis (Claude) from cited public sources; it may contain errors. Not investment advice. As of 27 Oct 2026 · Model: claude-haiku-5-5.
In brief
Castle Biosciences is a molecular diagnostics company offering genetic tests for dermatologic cancers, Barrett's esophagus, atopic dermatitis and uveal melanoma. Revenue grew in the first half of 2026 and full-year guidance was raised, which keeps the performance of TissueCypher and DecisionDx-Melanoma in focus. The company remains dependent on Medicare reimbursement and still reports historical accounting losses.
SWOT
Strengths
- The company has a broad base of published clinical evidence for its tests, which supports clinician adoption.
- Report volume growth for its core tests was strong in the first half of 2026.
- Most tests hold ADLT status, which helps set long-term Medicare reimbursement rates.
Weaknesses
- Revenue depends on a small number of payors, and Medicare is a large share of collections.
- The company has reported repeated net losses and carries a considerable accumulated deficit.
- Revenue recognition depends on estimates of partial payor payments, which makes quarterly results hard to compare.
Opportunities
- The AdvanceAD-Tx launch could open a much larger market than current ones if adoption grows.
- Integrating Previse technology could extend TissueCypher with new molecular markers.
- If reimbursement for DecisionDx-SCC changes, revenue from that test could recover.
Threats
- Changes in MAC policies or LCDs could reduce coverage for some tests.
- An unstable regulatory framework for laboratory tests could create compliance costs.
- Economic pressure and capital market swings could affect funding of development activities.
Risks
- Dependence on Medicare and one commercial payorhigh
A significant share of revenue comes from a small number of payors, and a cut in reimbursement could materially affect results.
- Quarterly revenue fluctuationsmedium
Estimates of partial reimbursement can change reported revenue from one period to the next, making comparisons difficult.
- Historical lossesmedium
The company has reported repeated losses and cannot state with certainty when it will become consistently profitable.
- Need for additional fundingmedium
If liquidity proves insufficient, the company could need additional capital, which could dilute shareholders.
- Changes in accounting and reporting standardslow
Changes in accounting standards can affect reported results and comparability across periods.
Investment thesis
What would need to be true (bull case)
- If the growth in TissueCypher volume holds, the raised 2026 guidance could be met and adjusted profitability could turn positive.
- The AdvanceAD-Tx launch could open a large market if clinical evidence persuades clinicians and payors.
- A substantial liquidity position provides room to invest in new tests and acquisitions.
What would break the thesis
- Dependence on Medicare and a few payors could make revenue vulnerable to policy changes.
- Repeated losses and high stock-based compensation could delay durable profitability.
- The loss of DecisionDx-SCC coverage shows a product can be removed from reimbursement, which could happen to other tests.
What to watch
- Quarterly results and the 2026 revenue guidanceQ3 2026
- Adoption of AdvanceAD-Tx and report volume after the limited access launch2026
- Final coverage decision for DecisionDx-SCC after reconsideration2026
- Annual report on financing plans and liquiditynext 10-K
Products, market & competition
AI-generatedAI-generated analysis (Claude) from cited public sources; it may contain errors. Not investment advice. As of 27 Oct 2026 · Model: claude-haiku-5-5.
The business
Castle Biosciences develops and sells molecular diagnostic tests that help clinicians diagnose and treat diseases, mainly skin cancers, Barrett's esophagus, atopic dermatitis and uveal melanoma, using algorithms on gene expression or spatial profiles 1. The company has delivered more than 419000 clinical test reports since inception 1. Net revenues for fiscal 2025 were 344.2 million USD, compared with 332.1 million USD in 2024 1. The revenue model depends on third-party payor reimbursement, and Medicare is a large share of collections 1. Also in 2025 the company acquired Capsulomics (Previse) and launched AdvanceAD-Tx on a limited access basis 1.
Segments
Dermatology
The dermatology segment includes DecisionDx-Melanoma, DecisionDx-SCC, MyPath Melanoma and AdvanceAD-Tx, with an estimated US TAM of 540 million USD for the first test 1. In the second quarter of 2026, DecisionDx-Melanoma delivered 10280 reports versus 9981 in the same period of 2025 3. DecisionDx-SCC fell to 4011 reports from 4762 after the change in Medicare coverage 3.
Gastroenterology and ophthalmology
TissueCypher, the Barrett's esophagus test, delivered 14988 reports in the second quarter of 2026 versus 9170 in 2025, and its US TAM is estimated at 1 billion USD 31. DecisionDx-UM, for uveal melanoma, remains a small segment with 482 reports in the second quarter of 2026 3.
Atopic dermatitis
AdvanceAD-Tx, launched on a limited access basis in November 2025, targets systemic treatment selection for moderate-to-severe atopic dermatitis, with an estimated US TAM of 33 billion USD 1. Report volume was de minimis in 2025, and the company received New York State assay approval for the test in July 2026 13.
Market context
The market for molecular diagnostic tests for skin cancers and digestive diseases is fragmented, and the company estimates its own potential markets test by test 1. For cutaneous melanoma the US TAM is estimated at 540 million USD, and for Barrett's esophagus at 1 billion USD 1. Atopic dermatitis could become a much larger market if AdvanceAD-Tx achieves broad adoption, given a TAM estimate of 33 billion USD 1.
Trends
- Pressure on Medicare reimbursementheadwind
Changes to DecisionDx-SCC coverage through LCDs finalized in 2025 reduced volume and revenue, and coverage for other tests depends on MAC decisions 12. If reimbursement rules change, the company could feel effects on revenue.
- Growth in Barrett's esophagus testingtailwind
TissueCypher report volume rose strongly, and in the first half of 2026 reports were well above 2025 levels 3. Continuation of this trend could support the raised 2026 revenue guidance.
- Regulation of laboratory testsmixed
The FDA rule on laboratory developed tests was vacated by a court and rescinded in 2025, and the company believes the effect on existing tests is not material 1. A more stable regulatory framework could reduce uncertainty.
- Investment in new products and acquisitionsmixed
The Previse acquisition and the SciBase collaboration extend the portfolio toward inflammatory skin disease and the esophagus 1. These investments could support long-term growth but raise development costs and execution risk.
Competitive position
Castle competes in genetic tests for diagnosis and risk stratification in dermatology, gastroenterology and ophthalmology, and the sources provided do not detail specific direct competitors 1. The company's stated advantage lies in published clinical evidence and ADLT status for most tests 12. Competitive pressure could increase if other laboratories obtain similar coverage from payors.
- Oncology diagnostic laboratories
The sources do not name specific competitors; the company refers only to general competition for its dermatology and gastroenterology tests.
- Atopic dermatitis test providers
AdvanceAD-Tx enters a new area; competition in this field is not detailed in the sources provided.
- Barrett's esophagus risk tests
The sources mention only that methylation and swallowable devices could expand the offering, without naming competitors.
- Melanoma test manufacturers
The company describes its own tests as clinically supported but does not specify competitors in the market.
Links, dependencies and risks
Who the company is tied to, from its own SEC filings (customers, suppliers, production, partners, competitors, countries, regulation), from the 5 %+ holders' statements (13D/13G) and from what other companies say about it. Click a node for its evidence; on a listed company the graph moves to it.
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News & filings
In the press
- Norman conquest castle and Dickens chalet among sites added to heritage at risk registerThe Guardian World · 05 Nov 2026 · EN
- Limp Bizkit, sombr, 5SOS și trio-ul olandez Noisia, primele nume mari confirmate la Electric Castle 2027. Cât costă bileteleLibertatea.ro · 03 Nov 2026 · RO
- Seven years after fire, Okinawa’s Shuri Castle inches away from reopeningThe Japan Times · 31 Oct 2026 · EN
- Police in Scotland launch Andrew and Epstein royal castle investigationAl Jazeera English · 30 Oct 2026 · EN
- Scottish police probe Andrew, Epstein stay at royal castle: U.K. mediaThe Hindu — International · 30 Oct 2026 · EN
- Scottish police probe Andrew, Epstein stay at royal castle: ReportsCNA (Channel NewsAsia) · 30 Oct 2026 · EN
- Untold, Electric Castle, Guitar Meeting și Beach, Please, printre nominalizările din România la European Festival Awards / A început votul publiculuiG4Media · 28 Oct 2026 · RO
- Culture council eyes Osaka Castle’s main tower as important cultural propertyThe Japan Times · 19 Oct 2026 · EN
- 12 Best Hotels in Edinburgh for Castle Views, Rooftop Tipples, and Cozy VibesConde Nast Traveler · 13 Oct 2026 · EN
- SAVE THE DATE: Electric Castle va avea loc între 15 și 18 iulie 2027Libertatea.ro · 12 Oct 2026 · RO
- Stocks making the biggest moves midday: T-Mobile, Verizon, AT&T, Crown Castle, Teva & moreCNBC — Top News · 09 Oct 2026 · EN
- ‘A real-life moment from The Castle’: the retired Australian couple who took on a coal giant and wonThe Guardian — Environment · 07 Oct 2026 · EN
- Electric Castle lansează o nouă colectă de haine uzate, pentru o viitoare colecție capsulă (Parteneriat)G4Media · 05 Oct 2026 · RO
- Kyoto plans dual pricing for Nijo Castle admission, bus faresThe Straits Times — Asia · 02 Oct 2026 · EN
- Kyoto plans to introduce dual pricing for World Heritage castleThe Japan Times · 01 Oct 2026 · EN
- Modern Object Pascal Introduction for Programmers – Castle Game EngineHacker News · 24 Sept 2026 · EN
- Here's What It's Like Shadowing a Blacksmith at Ashford Castle in Ireland—and How to Book the Experience YourselfConde Nast Traveler · 21 Sept 2026 · EN
- Crown Castle Cut Its Dividend. Is What Is Left Worth Owning for Income?Yahoo Finance — News · 21 Sept 2026 · EN
- 'Lost' medieval castle found hiding inside university building in DublinPhys.org · 18 Sept 2026 · EN
- Crown Castle Stock: Is CCI Underperforming the Real Estate Sector?Yahoo Finance — News · 09 Sept 2026 · EN
SEC filings
- Quarterly report30 Jul 2026
- Current report30 Jul 2026Results of operations · Regulation FD disclosure · Financial statements and exhibits
- Current report29 May 2026Shareholder vote
- Quarterly report06 May 2026
- Current report06 May 2026Results of operations · Regulation FD disclosure · Financial statements and exhibits
- Proxy statement08 Apr 2026
- Annual report26 Feb 2026
- Current report26 Feb 2026Results of operations · Regulation FD disclosure · Financial statements and exhibits
- Current report13 Jan 2026Results of operations · Regulation FD disclosure · Financial statements and exhibits
- Quarterly report03 Nov 2025
Sources
- [1] Form 10-K, fiscal year ended 2025-12-31 · SEC / Castle Biosciences, Inc. · 26 Feb 2026
- [2] Form 10-Q, quarter ended 2026-06-30 · SEC / Castle Biosciences, Inc. · 30 Jul 2026
- [3] Form 8-K, results release (exhibit 99.1) · SEC / Castle Biosciences, Inc. · 30 Jul 2026
Figures computed by olivLaw from SEC filings and closing prices; the qualitative analysis is AI-generated from cited sources. Not investment advice.