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Castle Biosciences, Inc. CSTL

Healthcare — Diagnostics & Research

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Insider Decisions

Total sells
17.50
in millions of $
Nov 25 Feb 26 May 26 Aug 26
Buy — — — — — — — — — — — —
Sell 3 9 8 2 1 8 2 2 3 6 9 3
Insider Ownership
1.64%

Capital & Financial Ratios

Market Cap
1,120.00
Revenue
357.28
Net Income
(19.41)
Free Cash Flow
(0.45)
Net Debt
(256.47)
Current Ratio
6.04
Debt/Equity
0.02
P/E ratio
0.00
P/S ratio
3.13
P/B ratio
2.38
Past 5Y EPS Growth
(28.57%)
This Y EPS Growth
(53.28%)
Next Y EPS Growth
22.27%
Next 5Y EPS Growth
24.16%
in millions of $

Dividends

Payout Ratio
0.00
Annual Dividend Rate
—
Annual Dividend Yield
—
total individual payouts
2023 ‡‡‡
2022 ‡‡‡
2021 ‡‡‡
2020 ‡‡‡
2019 ‡‡‡
2018 ‡‡‡
predictions in italic, special payouts not included in total or ratios

Assets vs Liabilities

2023 2024 2025 Q'26
Cash 243.10 293.13 299.51 266.81
Receivables 38.30 51.22 43.38 48.34
Inventory 7.94 8.14 10.25 10.58
Other — — — —
295.64 360.15 361.10 341.10
2023 2024 2025 Q'26
Payables 10.27 6.90 18.71 9.67
ST’ Debt — 0.28 0.42 2.92
Other — — 1.00 1.50
47.67 49.39 68.68 56.51
in millions of $

Compound Annual Growth

10y 5y 3y
Sales — ‡‡‡‡‡ ‡‡‡‡‡
Cash Flow — ‡‡‡‡‡ ‡‡‡
Earnings — ‡‡‡ ‡‡‡
Book Value — ‡‡‡‡‡ ‡‡‡‡‡

Revenue

Mar Jun Sep Dec Year
’26 83.68 103.55 — —
—
’25 87.99 86.19 83.04 87.01
344.23
’24 72.97 87.00 85.78 86.31
332.07
’23 42.04 50.14 61.49 66.12
219.79
’22 26.85 34.84 37.01 38.34
137.04
’21 22.81 22.76 23.48 25.04
94.09
’20 17.42 12.72 15.22 17.30
62.65
in millions of $

Operating Cash Flow

Mar Jun Sep Dec Year
’26 (22.13) 15.20 — —
—
’25 (6.04) 20.82 22.63 26.93
64.35
’24 (6.83) 24.00 23.34 24.37
64.87
’23 (25.44) (3.79) 5.01 18.59
(5.63)
’22 (21.43) (9.00) (5.22) (6.00)
(41.65)
’21 (3.63) (6.44) (6.13) (2.78)
(18.98)
’20 (0.25) 13.50 (2.95) (0.43)
9.87
in millions of $

Free Cash Flow

Mar Jun Sep Dec Year
’26 (34.58) 6.56 — —
—
’25 (10.77) 11.57 7.82 19.75
28.37
’24 (15.98) 18.77 16.96 16.81
36.56
’23 (28.77) (7.82) 2.56 14.80
(19.23)
’22 (21.83) (10.40) (7.26) (7.60)
(47.09)
’21 (4.38) (7.35) (7.06) (3.67)
(22.46)
’20 (0.75) 11.75 (4.86) (1.02)
5.12
in millions of $

EPS

Mar Jun Sep Dec Year
’26 (0.49) (0.07) — —
—
’25 (0.90) 0.15 (0.02) (0.08)
(0.83)
’24 (0.09) 0.31 0.08 0.32
0.62
’23 (1.10) (0.70) (0.26) (0.10)
(2.14)
’22 (0.97) (0.06) (0.77) (0.78)
(2.58)
’21 (0.17) (0.35) (0.47) (0.25)
(1.24)
’20 0.03 (0.08) (0.23) (0.23)
(0.54)

Target Price Range

High
‡‡‡‡‡
‡‡‡‡
Average
‡‡‡‡‡
‡‡‡‡
Low
‡‡‡‡‡
‡‡‡‡

Recommendation Rating

1.1
1
Buy
2
3
Hold
4
5
Sell
2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028
— — — ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ 15.58 9.26 16.97 14.59 — — —
Low Price
— — — ‡‡‡‡‡ ‡‡‡‡ ‡‡‡‡‡ 48.40 29.59 35.84 42.18 — — —
High Price
— — ‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ 543 610 761 883 — — —
Employees
— ‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ 0.25 0.36 0.44 0.39 — — —
Revenue/Emp
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ 137.04 219.79 332.07 344.23 ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡
Revenue
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ 76.64% 79.53% 81.87% 79.37% — — —
Gross Margin
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ (68.90) (57.36) 21.56 (29.51) ‡‡‡‡‡ — —
EBT
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ (50.28%) (26.10%) 6.49% (8.57%) ‡‡‡ ‡‡‡ ‡‡‡
EBT Margin
— ‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ (67.14) (57.47) 18.25 (24.16) ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡
Net Income
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ 9.18 6.84 9.31 36.55 — — —
Depreciation
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ 5.26 8.20 11.96 11.88 ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡
Revenue/Sh
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ (2.58) (2.14) 0.66 (0.83) ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡
Earnings/Sh
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ (1.60) (0.21) 2.34 2.22 ‡‡‡‡ — —
Cash Flow/Sh
— ‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ (0.21) (0.51) (1.02) (1.24) ‡‡‡ ‡‡‡ ‡‡‡
Capex/Sh
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ (1.81) (0.72) 1.32 0.98 — — —
Free CF/Sh
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ 15.32 14.60 16.41 16.24 ‡‡‡‡‡ — —
Book Value/Sh
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ 26.05 26.80 27.78 28.99 ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡
Shares
— ‡‡‡ ‡‡‡ ‡‡‡ ‡‡‡ ‡‡‡ 0.00 0.00 41.00 0.00 ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡
PE Ratio
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ 4.33 2.68 2.23 3.28 ‡‡‡ ‡‡‡ ‡‡‡
PS Ratio
— ‡‡‡ ‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ 1.49 1.50 1.62 2.39 ‡‡‡ ‡‡‡ ‡‡‡
PB Ratio
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ 2.54 1.64 1.38 2.44 ‡‡‡ ‡‡‡‡ ‡‡‡‡
EV/Sales
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ (7.39) (18.72) 12.51 29.55 — — —
EV/FCF
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ (41.65) (5.63) 64.87 64.35 ‡‡‡ ‡‡‡ ‡‡‡
Op' Cash Flow
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ (5.44) (13.61) (28.31) (35.98) ‡‡‡‡‡ ‡‡‡‡‡ —
Capex
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ (47.09) (19.23) 36.56 28.37 ‡‡‡‡‡ — —
FCF
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ 256.16 247.97 310.76 292.42 — — —
Working Cap'
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ — ‡‡‡‡‡ 13.31 — 10.33 10.37 — — —
Total Debt
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ (245.31) (243.10) (282.80) (289.13) — — —
Net Debt
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ 399.15 391.27 455.84 470.87 — — —
Sh' Equity
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ (14.76%) (12.76%) 3.71% (4.35%) ‡‡‡‡‡ — —
ROA
— ‡‡‡ ‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ (29.60%) (28.67%) 3.13% (14.72%) — — —
ROIC
— ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ ‡‡‡‡‡ (16.56%) (14.54%) 4.31% (5.21%) ‡‡‡‡‡ — —
ROE
predictions in italic, sparklines do not include predictions

Analyst Commentary (Summary)

Castle Biosciences (CSTL) has delivered explosive revenue growth, surging from $22.8 million in 2018 to $332 million in 2024—a 51% leap—fueled by hits like DecisionDx-Melanoma and expanding reimbursement in precision oncology. Efficiency shines with revenue per employee at $436k and gross margins at 81.9%, but this masks brutal profitability swings: deep losses through 2023 gave way to a $18.2 million net profit in 2024, only for analysts to forecast renewed red ink (-$0.90 EPS in 2025, -$1.31 in 2026) amid modest revenue growth (just 2% in 2025).

A fortress balance sheet—$283 million net cash, minimal debt—provides a safety net, yet heavy insider selling ($8.5 million, zero buys) and volatile FCF scream caution. Stock cratered 88% from 2021 highs despite tripling sales, now trading at tempting multiples (EV/Sales 1.38x, 24-57% upside to targets), but ROIC lags at 3.1% and execution risks loom large: regulatory hurdles, competition, and capex drains.

CSTL warrants a watchlist spot for contrarians eyeing downside protection, not moonshots—bet on the cash hoard while demanding proof of sustainable profits over hype.

Read full commentary →

Castle Biosciences, Inc. (CSTL) Latest News

News by impact score

Fine-tune

15 Sep

3 , 7:00 AM
A new decision modeling study shows Castle Biosciences' TissueCypher significantly improves risk-aligned management for Barrett's Esophagus patients. Positive study data on TissueCypher supports greater product adoption and revenue growth.

9 Sep

4 , 4:30 PM
JAAD publication demonstrates improved performance of Castle Biosciences DecisionDx-SCC test for cutaneous squamous cell carcinoma risk stratification. Positive clinical data on core diagnostic product can drive adoption, revenue and competitive edge for CSTL.

26 Aug

3 , 9:10 PM
Castle Biosciences (CSTL) shares rallied on optimism about upcoming earnings, raising questions on whether the stock remains undervalued after the move. Earnings optimism triggered a stock rally that can moderately influence short-term sentiment and valuation for Castle Biosciences.

13 Aug

4 www.marketbeat.com, 1:01 AM
Castle Biosciences raises its financial outlook due to rising adoption of its melanoma and TissueCypher diagnostic tests. Raised outlook plus expanding test traction signals major revenue growth and improved competitive positioning for Castle Biosciences.

31 Jul

4 transcript , 1:03 AM
Castle Biosciences Inc reported Q2 2026 revenue of $103 million, marking a 20% year-over-year increase. 20% revenue growth directly improves financial performance visibility and investor sentiment for CSTL.

3 transcript app.moby.co, 8:30 AM
Castle Biosciences, Inc. (CSTL) reported Q2 2026 financial results and business updates on its earnings call. Routine quarterly earnings update delivers financial metrics and outlook that can move near-term stock sentiment.

30 Jul

3 transcript www.marketbeat.com, 6:04 PM
Castle Biosciences Q2 earnings call covered financial results, operational updates and forward-looking guidance for the company. Quarterly earnings data can shift near-term investor views on financial performance but rarely drive lasting strategic change.

3 , 4:05 PM
Castle Biosciences reported financial results for the second quarter of 2026. Quarterly results update key financial metrics that shape near-term stock valuation.

14 Jul

4 , 4:30 PM
Castle Biosciences receives New York State Department of Health approval for its AdvanceAD-Tx test. New York approval expands market access for AdvanceAD-Tx test and supports revenue growth.

25 Jun

3 PR Newswire, 4:30 PM
DecisionDx-Melanoma i31-SLNB outperforms MIA Nomogram in identifying melanoma patients who can safely avoid sentinel lymph node biopsy. Positive clinical performance data on core melanoma test supports greater adoption and competitive positioning.

16 Jun

4 , 7:00 AM
Castle Biosciences' TissueCypher test has surpassed 100,000 orders, advancing precision risk assessment for Barrett's Esophagus patients. Surpassing 100,000 orders signals strong commercial traction for the core TissueCypher product, likely lifting revenue growth and investor sentiment.

24 May

3 Simply Wall St., 12:13 PM
Castle Biosciences posted solid Q1 results but faces lowered targets that shift its overall outlook and investor narrative. Solid Q1 results are offset by reduced targets that moderately influence near-term sentiment without altering long-term trajectory.

12 May

3 PR Newswire, 7:00 AM
Castle Biosciences' AdvanceAD-Tx™ Test received the 2026 MedTech Breakthrough Award for Genomics Innovation. Receiving a MedTech Breakthrough Award validates AdvanceAD-Tx innovation, likely enhancing competitive positioning and market sentiment without fundamentally transforming operations.

6 May

4 app.moby.co, 8:22 PM
Castle Biosciences, Inc. (CSTL) released Q1 2026 earnings call summary highlighting financial performance, operational updates, and future outlook. Quarterly earnings summaries reveal financial results and guidance that significantly shape market performance and investor expectations.

4 www.marketbeat.com, 8:07 PM
Castle Biosciences released Q1 earnings call highlights, covering financial results, operational updates, and future outlook. Q1 earnings highlights reveal financial performance and guidance that significantly sway investor sentiment and stock trajectory.

4 PR Newswire, 4:05 PM
Castle Biosciences, Inc. (CSTL) reported first quarter 2026 results, highlighting financial performance and operational updates. Quarterly earnings reports provide critical financial data that significantly affect stock price and investor sentiment.

3 Zacks, 6:30 PM
Castle Biosciences, Inc. (CSTL) reported a Q1 net loss but beat revenue estimates. Revenue beat despite Q1 loss affects financial performance and investor sentiment moderately.

5 May

4 Zacks, 9:55 AM
Wall Street analysts predict an 85.15% upside for Castle Biosciences (CSTL), highlighting strong buy ratings and elevated price targets based on robust growth prospects in cancer diagnostics. Analyst consensus of 85.15% upside reflects significant positive shift in market sentiment and potential stock trajectory.

4 May

4 PR Newswire, 7:00 AM
New data at DDW 2026 shows Castle Biosciences' TissueCypher® test improves risk stratification and drives risk-aligned management for Barrett's Esophagus patients. Positive clinical data at major conference validates TissueCypher® efficacy, likely increasing adoption, revenue, and investor confidence.

21 Apr

4 , 7:00 AM
Castle Biosciences will present new data at EADO and ACMS conferences showing DecisionDx-Melanoma identifies early-stage melanoma patients at greater risk of recurrence and poor outcomes. Presentation of validating clinical data for core melanoma diagnostic enhances product credibility and could drive adoption and investor sentiment.

4 Apr

4 Simply Wall St., 7:07 PM
Revenue assumptions are rewriting the story for Castle Biosciences (CSTL). Revised revenue assumptions signal major shifts in Castle Biosciences' financial trajectory and investor sentiment.

27 Mar

4 PR Newswire, 9:05 AM
Castle Biosciences' DecisionDx-Melanoma test significantly improves risk prediction within AJCC stages for cutaneous melanoma, enabling personalized, risk-aligned management; data to be presented at AAD 2026. Data validating superior risk prediction for key melanoma test at major dermatology conference boosts product credibility, adoption, and investor sentiment.

23 Mar

4 www.marketbeat.com, 6:36 PM
Castle Biosciences highlights DECIDE Study results showing DecisionDx-Melanoma refines sentinel lymph node biopsy (SLNB) decisions and improves recurrence risk stratification for melanoma patients. DECIDE Study validation strengthens DecisionDx-Melanoma's clinical utility in guiding SLNB and risk assessment, driving adoption and revenue growth for CSTL.

21 Mar

4 Simply Wall St., 12:14 AM
Narrative around Castle Biosciences (CSTL) shifting positively with new revenue targets. New revenue targets are shifting CSTL's investor narrative, signaling significant potential impact on future performance and market trajectory.

13 Mar

4 GlobeNewswire, 11:02 AM
Prospective multi-center study published in Future Oncology shows DecisionDx-Melanoma’s i31-SLNB result outperforms staging criteria in identifying cutaneous melanoma patients below 5% NCCN threshold for forgoing SLNB. Validation from peer-reviewed study enhances DecisionDx-Melanoma's credibility, likely driving adoption, revenue growth, and positive investor sentiment.

9 Mar

4 GlobeNewswire, 7:00 AM
Largest prospective multicenter study confirms DecisionDx-Melanoma’s i31-SLNB accurately predicts less than 5% nodal positivity risk, with actual 2.6% rate in those patients, supporting avoidance of unnecessary sentinel lymph node biopsies. Major clinical validation from largest study bolsters DecisionDx-Melanoma's evidence base, driving adoption and revenue growth for Castle Biosciences.

6 Mar

4 Simply Wall St., 1:07 PM
Castle Biosciences (CSTL) narrative shifts with new higher revenue targets and updated fair value estimates signaling improved growth prospects. New revenue targets and fair value updates represent major strategic guidance changes likely to boost investor sentiment and stock trajectory.

4 Mar

4 GlobeNewswire, 4:30 PM
Castle Biosciences to present at SSO 2026 data on DecisionDx-Melanoma’s i31-SLNB, identifying T1b–T2a melanoma patients who may safely avoid sentinel lymph node biopsy (SLNB). Data validating DecisionDx-Melanoma’s ability to safely spare low-risk patients from SLNB represents a major strategic advancement in clinical utility and market adoption.

27 Feb

4 app.moby.co, 8:30 AM
Castle Biosciences, Inc. released Q4 2025 earnings call summary detailing financial results, revenue growth, and future outlook. Q4 earnings summaries disclose key financials and guidance that drive significant shifts in investor sentiment and stock trajectory.

4 GuruFocus.com, 12:06 AM
Castle Biosciences Inc (CSTL) reported strong revenue growth in Q4 2025 earnings call highlights amidst challenges. Strong Q4 2025 revenue growth signals significant positive momentum for CSTL's financial performance and stock trajectory.
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