Founded in 2008, Castle Biosciences is a leading molecular diagnostics company focused on improving health through innovative tests that guide patient care. Realizing a large unmet clinical need in disease management, we continuously strive to evolve and improve, challenging the status quo with scientific expertise, value insights and robust data development.

Our innovative portfolio of commercial and pipeline tests targets unmet clinical need along the patient care continuum. We currently market six proprietary tests designed to answer clinical questions and address treatment plan challenges facing clinicians in dermatologic cancers, uveal melanoma, Barrett’s esophagus and mental health conditions. Our test for invasive cutaneous melanoma, DecisionDx®-Melanoma, is a proprietary gene expression profile (GEP) test that uses an individual patient’s tumor biology to predict the risk of metastasis or recurrence, as well as the risk of sentinel lymph node positivity, independent of traditional staging factors. DecisionDx®-SCC is our GEP test that predicts the risk of metastasis in patients with cutaneous squamous cell carcinoma, who have one or more risk factors. DecisionDx®-UM, the standard of care in uveal melanoma staging, is our GEP test that predicts the risk of metastasis for patients with uveal melanoma, a rare eye cancer. MyPath® Melanoma provides a highly accurate, objective result to aid dermatopathologists and dermatologists in characterizing suspicious pigmented lesions. The TissueCypher® Barrett’s Esophagus test is the world’s first precision medicine test designed to predict future development of esophageal cancer in patients with Barrett’s esophagus. IDgenetix® is a pharmacogenomic (PGx) test for depression, anxiety and other mental health conditions designed to analyze a patient’s genetic make-up to guide timely and evidence-based decisions on the optimal drug for each patient.

With an estimated U.S. Total Addressable Market (TAM) of approximately $8 billion for our commercially available tests and an additional estimated $5.7 billion market potential through our pipeline initiatives, we are well positioned to capitalize on the significant market opportunities available to us.

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Annual Report

2023 was an outstanding year for Castle, marked by strong growth that was propelled by our mission of improving health through innovative tests that guide patient care. Reflecting on our successes, I am extremely proud of what our team achieved, driven by our vibrant Castle culture and the hard work and dedication of our exceptional team members.

Our outstanding performance in 2023 builds upon our long track record of delivering consistent, strong results for our stakeholders. In 2023, we grew revenue approximately 60% year-over-year to $219.8 million. Additionally, we achieved our highest
ever test volumes, delivering 70,429 test reports to patients and providers, representing more lives changed through personalized, clinically actionable test results that can improve disease management decisions. And, this growth was achieved with judicious use of cash, i.e., net cash used in operating activities in 2023 was $5.6 million. Download PDF