Castle Biosciences Q1 Revenue $83.7M, Raises 2026 Revenue Guidance to $345M-$355M
Written by Emily J. Thompson, Senior Investment Analyst
Updated: May 06 2026
0mins
Should l Buy CSTL?
Reports Q1 revenue $83.7M, consensus $79.23M. "The Castle Biosciences team delivered outstanding results to start 2026, delivering $83.7M in revenue," said CEO Derek Maetzold. "Our momentum this quarter reflects our robust execution and the strength of our core revenue drivers, with both DecisionDx-Melanoma and TissueCypher achieving double digit year-over-year test volume growth, 16% and 58%, respectively. As a result of our first quarter performance and continued confidence in the business, we are raising our 2026 total revenue guidance to $345M-$355M vs. the previously provided guidance of $340M-350M. In addition, during the quarter we expanded the body of evidence supporting our market-leading DecisionDx-Melanoma test...Our substantial body of evidence is a key driver of adoption and an important differentiator for DecisionDx-Melanoma and our innovative test portfolio more broadly, reinforcing our position of strength as we continue to execute across the business."
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Analyst Views on CSTL
Wall Street analysts forecast CSTL stock price to rise
5 Analyst Rating
5 Buy
0 Hold
0 Sell
Strong Buy
Current: 18.880
Low
41.00
Averages
47.20
High
52.00
Current: 18.880
Low
41.00
Averages
47.20
High
52.00
About CSTL
Castle Biosciences, Inc. is a molecular diagnostics company offering test solutions to aid clinicians in the diagnosis and treatment of dermatologic cancers, Barrett’s esophagus (BE), uveal melanoma (UM), and in the treatment of mental health conditions. The Company offers around six commercially available proprietary multi-analyte assays with algorithmic analysis (MAAA) tests for use in the fields of dermatology, gastroenterology ophthalmology and includes a test to guide systemic treatment decisions in patients with moderate-to-severe AD. It also offers a proprietary pharmacogenomic (PGx) test to guide optimal drug treatment for patients diagnosed with depression, anxiety and other mental health conditions. Its products include DecisionDx-Melanoma, DecisionDx-SCC, MyPath Melanoma, TissueCypher, IDgenetix, and DecisionDx-UM. DecisionDx-SCC is its proprietary gene expression profile (GEP) test for patients with cutaneous squamous cell carcinoma (SCC).
About the author
Emily J. Thompson
Emily J. Thompson, a Chartered Financial Analyst (CFA) with 12 years in investment research, graduated with honors from the Wharton School. Specializing in industrial and technology stocks, she provides in-depth analysis for Intellectia’s earnings and market brief reports.
Castle Biosciences to Present at 2026 Jefferies Global Healthcare Conference
- Conference Presentation: Castle Biosciences is scheduled to present a company overview at the 2026 Jefferies Global Healthcare Conference on June 3 at 1:20 p.m. Eastern time, showcasing its innovative testing solutions aimed at improving health and attracting investor interest.
- Live Webcast Availability: The presentation will be available via live audio webcast on Castle Biosciences' website, allowing real-time access for attendees, with a replay option provided post-event to ensure that key information reaches all interested investors.
- Company Background: Castle Biosciences focuses on diagnostics for dermatologic and gastroenterological diseases, developing personalized, clinically actionable solutions that enhance disease management and patient outcomes, highlighting its innovative capabilities and market potential in the healthcare sector.
- Brand and Products: The company boasts a range of trademarks and products, including the DecisionDx series, underscoring its leadership in molecular testing and personalized medicine, which further solidifies its market share and influence in the diagnostics industry.
See More
Castle Biosciences Wins Genomics Innovation Award for AdvanceAD-Tx Test
- Award Recognition: Castle Biosciences' AdvanceAD-Tx test has been awarded the 'Genomics Innovation Award' at the 10th annual MedTech Breakthrough Awards, marking the fifth time the company has received this honor, underscoring its leadership in advancing medical technology.
- Clinical Validation Success: The AdvanceAD-Tx test utilizes a non-invasive skin scraping method to evaluate 487 genes, guiding systemic treatment decisions for patients aged 12 and older with moderate-to-severe atopic dermatitis, significantly enhancing the personalization of treatment options.
- Patient Outcome Improvement: In a prospective multi-center validation study, patients treated in alignment with their AdvanceAD-Tx results were 5.5 times more likely to achieve near-clear skin and did so 3.8 times faster than those receiving alternative therapies, highlighting the test's critical role in clinical applications.
- Enhanced Industry Impact: This award reflects the growing global influence of the digital healthcare sector, as Castle Biosciences drives improvements in patient care and healthcare value through its innovative solutions.
See More
Castle Biosciences Reports Strong Q1 2026 Earnings with Raised Revenue Guidance
- Significant Revenue Growth: Castle Biosciences reported $83.7 million in revenue for Q1 2026, a 36% increase year-over-year, reflecting strong performance in core revenue drivers, which bolstered market confidence and prompted an upward revision of the 2026 revenue outlook to $345 million to $355 million.
- Increased Test Report Volume: The company delivered 10,021 test reports for DecisionDx-Melanoma in Q1, representing a 16% year-over-year growth, while TissueCypher reports surged from 7,432 in 2025 to 11,745, marking a remarkable 58% increase, indicating sustained demand for its products.
- Improved Gross Margin: The gross margin for Q1 2026 was 72.8%, significantly up from 49.2% in Q1 2025, showcasing substantial improvements in cost control and operational efficiency, although the adjusted gross margin slightly decreased to 75.6%.
- Cash Flow Position: As of March 31, 2026, Castle Biosciences had $261.7 million in cash, cash equivalents, and marketable securities; despite a net loss of $14.5 million in Q1, the company anticipates that future M&A activities will drive growth and enhance financial stability.
See More
Castle Biosciences Unveils New Data on Melanoma Risk Assessment
- Clinical Data Presentation: Castle Biosciences will present data from a study of 1,817 early-stage melanoma patients at the 2026 EADO Congress, demonstrating that the DecisionDx-Melanoma test provides independent, personalized prognostic information beyond AJCC staging, thereby aiding physicians in more precise risk management.
- Risk Identification Capability: The test identifies recurrence risks in patients with thin tumors, revealing that their recurrence rates are comparable to those of higher-stage patients, which underscores the need for precise clinical management decisions in early-stage disease.
- Survival Rate Analysis: At the ACMS meeting, Castle will share an analysis based on SEER registry data showing that DecisionDx-Melanoma can identify molecularly high-risk T1a and T1b patients with significantly lower 5-year melanoma-specific survival, highlighting the importance of managing low-risk populations effectively.
- Personalized Management Decisions: By integrating molecular insights with clinicopathologic features, DecisionDx-Melanoma provides personalized assessments of sentinel lymph node positivity and recurrence risk, enabling clinicians to make more informed management decisions early on, consistent with National Comprehensive Cancer Network guideline risk thresholds.
See More
Castle Biosciences to Release Q1 2026 Financial Results on May 6
- Earnings Release Schedule: Castle Biosciences will announce its Q1 2026 financial results after market close on May 6, 2026, demonstrating the company's commitment to financial transparency, which is expected to positively impact investor confidence.
- Webcast Discussion: Management will host a live webcast at 4:30 p.m. Eastern Time on the same day to discuss the financial results and hold a Q&A session, aimed at enhancing investor engagement and providing deeper financial insights.
- Focus on Innovative Testing: Castle Biosciences specializes in innovative tests for dermatologic and gastroenterological diseases, striving to improve patient management and outcomes through personalized clinical solutions, reflecting the company's strategic positioning in the healthcare sector.
- Brand and Market Promotion: The company actively promotes its brand and products through its website and social media platforms, enhancing public awareness of its innovative tests, with the goal of increasing market share and attracting more patients and clinicians' attention.
See More
Castle Biosciences Wins 2026 USA TODAY Top Workplaces Award for Fifth Year
- Consecutive Award Achievement: Castle Biosciences has won the 2026 USA TODAY Top Workplaces Award for the fifth consecutive year, reflecting the company's ongoing commitment to employee care and culture building, which enhances its reputation and attractiveness in the healthcare industry.
- Employee Feedback Driven: The award is based on employee feedback collected through a third-party survey, indicating the company's high performance in employee experience, which further boosts its credibility among job seekers and customers.
- Cultural Investment Commitment: CEO Derek Maetzold emphasized that building a people-first culture is a continuous investment process, ensuring that employees feel valued and supported, thereby increasing employee loyalty and job satisfaction.
- Industry Impact: Winning this award not only recognizes the company's culture but also establishes a positive corporate image for Castle Biosciences in a competitive market, attracting more top talent and driving business growth.
See More
Castle Biosciences to Present at 2026 Jefferies Global Healthcare Conference
- Conference Presentation: Castle Biosciences is scheduled to present a company overview at the 2026 Jefferies Global Healthcare Conference on June 3 at 1:20 p.m. Eastern time, showcasing its innovative testing solutions aimed at improving health and attracting investor interest.
- Live Webcast Availability: The presentation will be available via live audio webcast on Castle Biosciences' website, allowing real-time access for attendees, with a replay option provided post-event to ensure that key information reaches all interested investors.
- Company Background: Castle Biosciences focuses on diagnostics for dermatologic and gastroenterological diseases, developing personalized, clinically actionable solutions that enhance disease management and patient outcomes, highlighting its innovative capabilities and market potential in the healthcare sector.
- Brand and Products: The company boasts a range of trademarks and products, including the DecisionDx series, underscoring its leadership in molecular testing and personalized medicine, which further solidifies its market share and influence in the diagnostics industry.
See More
Castle Biosciences Wins Genomics Innovation Award for AdvanceAD-Tx Test
- Award Recognition: Castle Biosciences' AdvanceAD-Tx test has been awarded the 'Genomics Innovation Award' at the 10th annual MedTech Breakthrough Awards, marking the fifth time the company has received this honor, underscoring its leadership in advancing medical technology.
- Clinical Validation Success: The AdvanceAD-Tx test utilizes a non-invasive skin scraping method to evaluate 487 genes, guiding systemic treatment decisions for patients aged 12 and older with moderate-to-severe atopic dermatitis, significantly enhancing the personalization of treatment options.
- Patient Outcome Improvement: In a prospective multi-center validation study, patients treated in alignment with their AdvanceAD-Tx results were 5.5 times more likely to achieve near-clear skin and did so 3.8 times faster than those receiving alternative therapies, highlighting the test's critical role in clinical applications.
- Enhanced Industry Impact: This award reflects the growing global influence of the digital healthcare sector, as Castle Biosciences drives improvements in patient care and healthcare value through its innovative solutions.
See More
Castle Biosciences Reports Strong Q1 2026 Earnings with Raised Revenue Guidance
- Significant Revenue Growth: Castle Biosciences reported $83.7 million in revenue for Q1 2026, a 36% increase year-over-year, reflecting strong performance in core revenue drivers, which bolstered market confidence and prompted an upward revision of the 2026 revenue outlook to $345 million to $355 million.
- Increased Test Report Volume: The company delivered 10,021 test reports for DecisionDx-Melanoma in Q1, representing a 16% year-over-year growth, while TissueCypher reports surged from 7,432 in 2025 to 11,745, marking a remarkable 58% increase, indicating sustained demand for its products.
- Improved Gross Margin: The gross margin for Q1 2026 was 72.8%, significantly up from 49.2% in Q1 2025, showcasing substantial improvements in cost control and operational efficiency, although the adjusted gross margin slightly decreased to 75.6%.
- Cash Flow Position: As of March 31, 2026, Castle Biosciences had $261.7 million in cash, cash equivalents, and marketable securities; despite a net loss of $14.5 million in Q1, the company anticipates that future M&A activities will drive growth and enhance financial stability.
See More
Castle Biosciences Unveils New Data on Melanoma Risk Assessment
- Clinical Data Presentation: Castle Biosciences will present data from a study of 1,817 early-stage melanoma patients at the 2026 EADO Congress, demonstrating that the DecisionDx-Melanoma test provides independent, personalized prognostic information beyond AJCC staging, thereby aiding physicians in more precise risk management.
- Risk Identification Capability: The test identifies recurrence risks in patients with thin tumors, revealing that their recurrence rates are comparable to those of higher-stage patients, which underscores the need for precise clinical management decisions in early-stage disease.
- Survival Rate Analysis: At the ACMS meeting, Castle will share an analysis based on SEER registry data showing that DecisionDx-Melanoma can identify molecularly high-risk T1a and T1b patients with significantly lower 5-year melanoma-specific survival, highlighting the importance of managing low-risk populations effectively.
- Personalized Management Decisions: By integrating molecular insights with clinicopathologic features, DecisionDx-Melanoma provides personalized assessments of sentinel lymph node positivity and recurrence risk, enabling clinicians to make more informed management decisions early on, consistent with National Comprehensive Cancer Network guideline risk thresholds.
See More
Castle Biosciences to Release Q1 2026 Financial Results on May 6
- Earnings Release Schedule: Castle Biosciences will announce its Q1 2026 financial results after market close on May 6, 2026, demonstrating the company's commitment to financial transparency, which is expected to positively impact investor confidence.
- Webcast Discussion: Management will host a live webcast at 4:30 p.m. Eastern Time on the same day to discuss the financial results and hold a Q&A session, aimed at enhancing investor engagement and providing deeper financial insights.
- Focus on Innovative Testing: Castle Biosciences specializes in innovative tests for dermatologic and gastroenterological diseases, striving to improve patient management and outcomes through personalized clinical solutions, reflecting the company's strategic positioning in the healthcare sector.
- Brand and Market Promotion: The company actively promotes its brand and products through its website and social media platforms, enhancing public awareness of its innovative tests, with the goal of increasing market share and attracting more patients and clinicians' attention.
See More
Castle Biosciences Wins 2026 USA TODAY Top Workplaces Award for Fifth Year
- Consecutive Award Achievement: Castle Biosciences has won the 2026 USA TODAY Top Workplaces Award for the fifth consecutive year, reflecting the company's ongoing commitment to employee care and culture building, which enhances its reputation and attractiveness in the healthcare industry.
- Employee Feedback Driven: The award is based on employee feedback collected through a third-party survey, indicating the company's high performance in employee experience, which further boosts its credibility among job seekers and customers.
- Cultural Investment Commitment: CEO Derek Maetzold emphasized that building a people-first culture is a continuous investment process, ensuring that employees feel valued and supported, thereby increasing employee loyalty and job satisfaction.
- Industry Impact: Winning this award not only recognizes the company's culture but also establishes a positive corporate image for Castle Biosciences in a competitive market, attracting more top talent and driving business growth.
See More
