Castle Biosciences' TissueCypher® Test Surpasses 100,000 Orders, Advancing Precision Risk Assessment for Patients with Barrett's Esophagus

FRIENDSWOOD, Texas, June 16, 2026 /PRNewswire/ -- Castle Biosciences, Inc. (Nasdaq: CSTL), a company improving health through innovative tests that guide patient care, today announced that its TissueCypher^® Barrett's Esophagus Test has surpassed 100,000 clinical test orders. TissueCypher is an AI-derived precision medicine test designed to predict a patient's five-year risk of progression from Barrett's esophagus (BE) to high-grade dysplasia or esophageal adenocarcinoma.

"Barrett's esophagus (BE) is the only known precursor to esophageal adenocarcinoma (EAC), a gastrointestinal cancer associated with poor survival outcomes," said Emmanuel Gorospe, M.D., MPH, FACG, FASGE, board-certified gastroenterologist and medical director at Castle Biosciences.^1,2 "TissueCypher provides clinically validated risk stratification for patients with BE by identifying those at increased risk of progression to high-grade dysplasia or EAC. It can help clinicians tailor management decisions based on an individual patient's risk profile, including consideration of intensified surveillance or endoscopic eradication therapy for high-risk patients and appropriate routine surveillance for low-risk patients."

"Reaching 100,000 orders reflects the growing use of TissueCypher to provide patients with more personalized information about their risk of progression," said Toby Juvenal, chief commercial officer of Castle Biosciences. "We are grateful to the clinicians who have incorporated TissueCypher into the management of patients with Barrett's esophagus and to the patients who continue to advocate for more informed approaches to their care."

For some patients, understanding their risk of progression may help reduce uncertainty after diagnosis. Robin Byrd Wilfong, a patient diagnosed with BE, received a low-risk TissueCypher result indicating a 2% chance of progression over five years. "I don't feel like a ticking time bomb," she said. "I feel like I've got time to manage this the way I choose."

To learn more about Robin's experience with TissueCypher, watch her story here.

About TissueCypher Barrett's Esophagus Test
TissueCypher is a precision medicine test designed and extensively validated to predict a patient's personalized risk of progression from Barrett's esophagus (BE) to high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC). Indicated for patients with non-dysplastic BE, indefinite for dysplasia or with low-grade dysplasia, TissueCypher's five-year risk assessment is designed to help physicians tailor care to each patient's risk of developing HGD or EAC.

Backed by more than 17 peer-reviewed publications and studied in biopsies from more than 8,000 patients, TissueCypher has been shown to be the strongest independent predictor of progression compared with traditional histopathological risk assessment. Using an AI-derived spatialomics approach, the test identifies molecular signatures that often precede the development of dysplasia, which can enable earlier identification, treatment, and management of patients at increased risk of cancer. TissueCypher is designed to integrate seamlessly into routine endoscopic practice by analyzing standard esophageal pinch biopsies, delivering actionable insights without requiring additional procedures. Learn more at CastleBiosciences.com/TissueCypher.

About Castle Biosciences 
Castle Biosciences (Nasdaq: CSTL) is a leading diagnostics company improving health through innovative tests that guide patient care. With a primary focus in dermatologic and gastroenterological disease, we develop personalized, clinically actionable solutions that help improve disease management and patient outcomes. 

We put people first—empowering patients and clinicians and informing care decisions through rigorous science and advanced molecular tests that support more confident treatment planning. To learn more, visit www.CastleBiosciences.com and connect with us on LinkedIn, Instagram, Facebook and X.

DecisionDx-Melanoma, DecisionDx-CMSeq, i31-SLNB, i31-ROR, DecisionDx-SCC, MyPath Melanoma, AdvanceAD-Tx, TissueCypher, Esopredict, DecisionDx-UM, DecisionDx-PRAME and DecisionDx-UMSeq are trademarks of Castle Biosciences, Inc.

Forward-Looking Statements
This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, which are subject to the "safe harbor" created by those sections. These forward-looking statements include, but are not limited to, statements concerning: TissueCypher's ability to (i) predict a patient's personalized risk of progression from Barrett's esophagus to high-grade dysplasia or esophageal adenocarcinoma, (ii) help clinicians tailor surveillance and management decisions to each patient's individual risk profile, (iii) enable earlier identification and management of patients at increased risk of cancer, and (iv) help reduce uncertainty for patients. The words "believe," "can," "may" and similar expressions are intended to identify forward-looking statements, although not all forward-looking statements contain these identifying words. We may not actually achieve the plans, intentions or expectations disclosed in our forward-looking statements, and you should not place undue reliance on our forward-looking statements. Actual results or events could differ materially from the plans, intentions and expectations disclosed in the forward-looking statements that we make. These forward-looking statements involve risks and uncertainties that could cause our actual results to differ materially from those in the forward-looking statements, including, without limitation: subsequent study or trial results and findings may contradict earlier study or trial results and findings or may not support the results obtained in these studies, including with respect to the discussion of our tests in this press release; actual application of our tests may not provide the aforementioned benefits to patients; and the risks set forth under the heading "Risk Factors" in our Annual Report on Form 10-K for the year ended December 31, 2025, and our subsequent Quarterly Reports on Form 10-Q, each as filed or to be filed with the SEC, and in our other filings with the SEC. The forward-looking statements are applicable only as of the date on which they are made, and we do not assume any obligation to update any forward-looking statements, except as may be required by law.

1. Katzka DA, Spechler SJ, Fitzgerald RC, et al. AGA clinical practice update on new technology and innovation for surveillance and screening in Barrett's esophagus: expert review. Gastroenterology. Published online April 23, 2025. doi:10.1053/j.gastro.2025.04.021
2. World Cancer Research Fund International. Less survivable cancers and what can be done about them. Published January 3, 2023. Accessed May 20, 2026. https://www.wcrf.org/less-survivable-cancers/

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SOURCE Castle Biosciences, Inc.