Castle Biosciences Reports $103.5M Revenue in Q2 2026, Driven by Non-Dermatologic Test Growth

Castle Biosciences, Inc. reported a net revenue of $103.5 million for the second quarter of 2026, marking a 20.1% increase from $86.2 million in the same period of 2025. For the first half of 2026, the company generated $187.2 million in revenue, a 7.5% rise compared to $174.2 million in the first half of 2025. The growth in revenue was primarily driven by a significant increase in test report volumes for its non-dermatologic tests, particularly the TissueCypher test for Barrett's esophagus, which saw a 61% increase in report volumes. However, revenues from dermatologic tests, particularly the DecisionDx-SCC test, decreased due to lower average selling prices and test volumes following the loss of Medicare coverage in April 2025.

The company's operating expenses for the second quarter of 2026 totaled $106.6 million, up from $90.4 million in the prior year, reflecting a 17.9% increase. This rise was attributed to higher costs in sales, research and development, and general administrative expenses. Despite the increase in expenses, Castle Biosciences reported an operating loss of $3.1 million for the quarter, an improvement from a loss of $4.3 million in the same quarter of 2025. The net loss for the second quarter was $2.1 million, compared to a net income of $4.5 million in the prior year, largely due to changes in revenue recognition and increased operational costs.

In terms of strategic developments, Castle Biosciences expanded its product offerings with the limited access launch of the AdvanceAD-Tx test for atopic dermatitis in late 2025. The company also completed the acquisition of Capsulomics, Inc. in May 2025, which is expected to enhance its capabilities in the Barrett's esophagus market. As of June 30, 2026, the company had 1,002 employees, up from 798 a year earlier, reflecting its ongoing investment in expanding its workforce to support growth.

Operationally, Castle Biosciences delivered a total of 57,755 test reports in the first half of 2026, a 13% increase compared to the same period in 2025. The increase was driven by strong performance in its core products, particularly the TissueCypher and DecisionDx-Melanoma tests. The company continues to focus on expanding its laboratory operations to accommodate growing test volumes. As of June 30, 2026, Castle Biosciences had cash and cash equivalents of $62.1 million and marketable investment securities of $204.7 million, which management believes will be sufficient to fund operations for at least the next 12 months.

Looking ahead, Castle Biosciences anticipates continued growth in revenue driven by increased adoption of its existing tests and the successful launch of new products. However, the company remains cautious about potential impacts from macroeconomic conditions, including inflation and changes in reimbursement policies, which could affect its financial performance. The management is committed to maintaining Medicare coverage for its tests and expanding its market presence to support long-term growth.