{"success":true,"data":{"pressRelease":{"id":"166818","rtpr_id":"nPn24fqY4a-20261012","ticker":"CSTL","exchange":"NASDAQ","all_tickers":["CSTL"],"title":"ACG 2026 Data Show TissueCypher® Identifies Elevated Risk of Progression Beyond Pathology Findings in Barrett's Esophagus","author":"PR Newswire","published_at":"2026-10-12T20:30:00.227Z","article_body":"ACG 2026 Data Show TissueCypher® Identifies Elevated Risk of Progression Beyond Pathology Findings in Barrett's Esophagus\nPR Newswire\n\nFRIENDSWOOD, Texas, Oct. 12, 2026\n\nStudies highlight how molecular risk assessment with TissueCypher can help\ninform surveillance and treatment decisions beyond biopsy findings alone\n\nFRIENDSWOOD, Texas, Oct. 12, 2026 /PRNewswire/ -- Castle Biosciences, Inc.\n(Nasdaq: CSTL), a company improving health through innovative tests that guide\npatient care, today announced that new data from three studies evaluating its\nTissueCypher Barrett's Esophagus (BE) test will be presented at the American\nCollege of Gastroenterology (ACG) 2026 Annual Scientific Meeting and\nPostgraduate Course, taking place Oct. 9-14 in Nashville, Tennessee. The\nstudies include two case reports and one multi-center study highlighting how\nTissueCypher can provide additional risk information beyond histopathology to\nsupport risk-aligned patient management decisions.\n\n\"Endoscopic biopsy findings do not always tell the whole story when it comes\nto a patient's risk of progression,\" said study author Virendra Joshi, M.D.,\nFAGA, FACG, board-certified gastroenterologist and associate professor in the\nDivision of Digestive Diseases in the Department of Medicine at Emory\nUniversity School of Medicine in Atlanta. \"The studies being presented at ACG\ndemonstrate how TissueCypher can complement standard pathology by providing\nobjective molecular risk information that helps guide surveillance and\ntreatment decisions for patients with Barrett's esophagus, particularly when a\npatient's molecular risk suggests a different approach than their biopsy\ndiagnosis alone would indicate.\"\n\nBE is a precancerous condition associated with an increased risk of esophageal\nadenocarcinoma (EAC), yet biopsy findings alone do not always accurately\nreflect a patient's individual biological risk of progression. TissueCypher\nanalyzes protein biomarkers and tissue architecture in routine endoscopic\nbiopsy samples to provide an individualized five-year probability of\nprogression to high-grade dysplasia (HGD) or EAC.\n\nStudy findings and presentation details are included below. All posters will\nbe presented in Exhibit Halls A-D (Level 3) at Music City Center.\n\nP3056: The Tissue Systems Pathology Test Enabled Detection of Missed Prevalent\nDysplasia in a Presumed Clinically Low-Risk Patient With Non-Dysplastic\nBarrett's Esophagus\n\n * Presenting author: Salih Samo, M.D., University of Kansas School of Medicine\n * Date and Time: Monday, Oct. 12; 10:30 a.m.-4:15 p.m. Central time\n * Key findings: According to gastroenterology society guidelines, patients\ndiagnosed with non-dysplastic BE (NDBE) are generally recommended to undergo\nsurveillance endoscopy every three to five years because they are considered\nat relatively low risk of progression. However, biopsy findings alone may not\nfully reflect a patient's underlying biological risk, and some patients may\nharbor advanced precancerous changes that cannot be detected through routine\nhistopathologic assessment alone. In this case report, TissueCypher returned a\nhigh-risk result for a patient with NDBE, indicating a 62% probability of\nprogression to HGD or EAC within five years. The result informed a risk-based\nmanagement approach and led to a repeat endoscopy six months after the initial\nexamination, at which previously missed prevalent HGD was identified. The\npatient subsequently underwent endoscopic eradication therapy (EET) with\nradiofrequency ablation (RFA). This case illustrates how TissueCypher may help\nidentify elevated risk among patients with an NDBE diagnosis, helping\nclinicians identify patients who may benefit from earlier evaluation and\nintervention than would otherwise be recommended based on histology alone.\nP5192: Real-World Impact of Tissue Systems Pathology Test on Barrett's\nEsophagus Management: A Multi-Center Cohort Study\n\n * Presenting author: Shree Patel, M.D., Emory University School of Medicine\n * Date and Time: Tuesday, Oct. 13; 10:30 a.m.-4 p.m. Central time\n * Key findings: Histopathology and clinical factors alone may not fully\nidentify which patients with BE are at elevated risk of progression to\nHGD/EAC. In the study, molecular risk stratification using TissueCypher was\ncompared with the Progression in Barrett's (PIB) clinicopathologic-based risk\nstratification approach. There was only slight agreement between the two\napproaches (Cohen's κ = 0.04). TissueCypher classified 83% of patients as low\nrisk and 17% as intermediate/high risk, whereas the PIB score classified 31%\nof patients as low risk and 69% as intermediate/high risk. Following\nTissueCypher testing, management recommendations were changed in a manner\nconsistent with the test's risk classification for 96% of patients in this\ncohort, suggesting that the results informed clinical decision-making in this\nstudy population. Under guideline-informed management, most patients would\nhave been recommended surveillance every three years using the PIB approach.\nHowever, guided by TissueCypher results, physicians recommended a longer\nfive-year surveillance window for 38 patients and EET for eight, which\nincluded five patients with NDBE whose TissueCypher results indicated\nintermediate or high risk or progression despite having no dysplasia detected\non their biopsy. These findings suggest that TissueCypher may provide\nadditional risk information beyond clinicopathologic assessment to support\nmore individualized surveillance and treatment recommendations.\nP5296: The Tissue Systems Pathology Test Facilitated Early Intervention in a\nHistopathologically Complex Case of Barrett's Esophagus\n\n * Presenting author: Shree Patel, M.D., Emory University School of Medicine\n * Date and Time: Tuesday, Oct. 13; 10:30 a.m.-4 p.m. Central time\n * Key findings: Conflicting biopsy results can make it difficult to determine\nthe appropriate management strategy for patients with BE. In this case, a\npatient's biopsies were successively classified as NDBE, low-grade dysplasia\n(LGD) and indefinite for dysplasia (IND), creating uncertainty about the\npatient's risk and management plan. TissueCypher testing of the IND biopsy\nreturned a high-risk result, indicating a 47% probability of progression to\nHGD or EAC within five years. The high-risk result prompted an interventional\nendoscopy with RFA two months after the endoscopy that yielded the IND\ndiagnosis. Biopsies obtained during the procedure confirmed previously\nundetected HGD, consistent with the TissueCypher high-risk classification.\nFollowing RFA and subsequent cryotherapy, follow-up biopsies confirmed\ncomplete eradication of the patient's intestinal metaplasia. This case\nillustrates how TissueCypher may help reduce uncertainty for patients with\ninconclusive or discordant biopsy findings by providing objective risk\ninformation that supports timely intervention and individualized patient\nmanagement.\nTissueCypher Product Theater\n\n * Date and Time: Tuesday, Oct. 13; 1:15-1:45 p.m. Central time\n * Location: Product Theater Area (Booth 117)\n * Castle will host a product theater titled, \"Low-risk on histology. High-risk\nin reality: Johnny Walker's journey with Barrett's esophagus.\" During the\nsession, TissueCypher patient ambassador Johnny Walker will join Mark\nAmorosino, M.D., gastroenterologist at Gastro Health, and David Forcione,\nM.D., advanced endoscopist at Baptist Health, to discuss how TissueCypher's\nmolecular risk assessment provided additional insight beyond his NDBE\ndiagnosis and informed treatment decisions that ultimately led to the\ndetection of dysplasia.\nFor more information on TissueCypher, visit Castle at Booth 1706.\n\nAbout TissueCypher Barrett's Esophagus Test\nTissueCypher is a precision medicine test designed and extensively validated\nto predict a patient's personalized risk of progression from Barrett's\nesophagus (BE) to high-grade dysplasia (HGD) or esophageal adenocarcinoma\n(EAC). Indicated for patients with non-dysplastic BE, indefinite for dysplasia\nor with low-grade dysplasia, TissueCypher's five-year risk assessment is\ndesigned to help physicians tailor care to each patient's risk of developing\nHGD or EAC.\n\nBacked by more than 17 peer-reviewed publications and studied in biopsies\nfrom more than 8,000 patients, TissueCypher has been shown to be the strongest\nindependent predictor of progression compared with traditional\nhistopathological risk assessment. Using an AI-derived spatialomics approach,\nthe test identifies molecular signatures that often precede the development of\ndysplasia, which can enable earlier identification, treatment, and management\nof patients at increased risk of cancer. TissueCypher is designed to integrate\nseamlessly into routine endoscopic practice by analyzing standard esophageal\npinch biopsies, delivering actionable insights without requiring additional\nprocedures. Learn more at CastleBiosciences.com/TissueCypher\n(https://edge.prnewswire.com/c/link/?t=0&l=en&o=4795731-1&h=3094218765&u=https%3A%2F%2Fedge.prnewswire.com%2Fc%2Flink%2F%3Ft%3D0%26l%3Den%26o%3D4711582-1%26h%3D3125422294%26u%3Dhttp%253A%252F%252Fcastlebiosciences.com%252Ftissuecypher%26a%3DCastleBiosciences.com%252FTissueCypher&a=CastleBiosciences.com%2FTissueCypher)\n.\n\nAbout Castle Biosciences\nCastle Biosciences (Nasdaq: CSTL) is a leading diagnostics company improving\nhealth through innovative tests that guide patient care. With a primary focus\nin dermatologic and gastroenterological disease, we develop personalized,\nclinically actionable solutions that help improve disease management and\npatient outcomes.\n\nWe put people first—empowering patients and clinicians and informing care\ndecisions through rigorous science and advanced molecular tests that support\nmore confident treatment planning. To learn more,\nvisit www.CastleBiosciences.com\n(https://edge.prnewswire.com/c/link/?t=0&l=en&o=4795731-1&h=3620373660&u=http%3A%2F%2Fwww.castlebiosciences.com%2F&a=www.CastleBiosciences.com)\n and connect with us on LinkedIn\n(https://edge.prnewswire.com/c/link/?t=0&l=en&o=4795731-1&h=3797892228&u=https%3A%2F%2Fwww.linkedin.com%2Fcompany%2Fcastle-biosciences-inc-%2F&a=LinkedIn)\n, Instagram\n(https://edge.prnewswire.com/c/link/?t=0&l=en&o=4795731-1&h=1175666527&u=https%3A%2F%2Fwww.instagram.com%2Fcastlebiosciences%2F&a=Instagram)\n, Facebook\n(https://edge.prnewswire.com/c/link/?t=0&l=en&o=4795731-1&h=29659263&u=https%3A%2F%2Fwww.facebook.com%2Fcastlebiosciences%2F&a=Facebook)\n and X\n(https://edge.prnewswire.com/c/link/?t=0&l=en&o=4795731-1&h=3962974639&u=https%3A%2F%2Ftwitter.com%2Fcastlebio%3Flang%3Den&a=X)\n. \n\nDecisionDx-Melanoma, DecisionDx-CMSeq, i31-SLNB, i31-ROR, DecisionDx-SCC,\nMyPath Melanoma, AdvanceAD-Tx, TissueCypher, Esopredict, DecisionDx-UM,\nDecisionDx-PRAME and DecisionDx-UMSeq are trademarks of Castle Biosciences,\nInc.\n\nForward-Looking Statements\nThis press release contains forward-looking statements within the meaning of\nSection 27A of the Securities Act of 1933, as amended, and Section 21E of the\nSecurities Exchange Act of 1934, as amended, which are subject to the \"safe\nharbor\" created by those sections. These forward-looking statements include,\nbut are not limited to, statements concerning: TissueCypher's ability to (i)\npredict a patient's personalized risk of progression from Barrett's esophagus\nto high-grade dysplasia or esophageal adenocarcinoma, (ii) help clinicians\ntailor surveillance and management decisions to each patient's individual risk\nprofile, (iii) enable earlier identification and management of patients at\nincreased risk of cancer, (iv) help reduce uncertainty for patients, and (v)\nperform favorably as compared with traditional histopathological risk\nassessment and integrate into routine clinical workflows. The words \"believe,\"\n\"can,\" \"may\" and similar expressions are intended to identify forward-looking\nstatements, although not all forward-looking statements contain these\nidentifying words. We may not actually achieve the plans, intentions or\nexpectations disclosed in our forward-looking statements, and you should not\nplace undue reliance on our forward-looking statements. Actual results or\nevents could differ materially from the plans, intentions and expectations\ndisclosed in the forward-looking statements that we make. These\nforward-looking statements involve risks and uncertainties that could cause\nour actual results to differ materially from those in the forward-looking\nstatements, including, without limitation: subsequent study or trial results\nand findings may contradict earlier study or trial results and findings or may\nnot support the results obtained in these studies, including with respect to\nthe discussion of our tests in this press release; actual application of our\ntests may not provide the aforementioned benefits to patients; and the risks\nset forth under the heading \"Risk Factors\" in our Annual Report on Form 10-K\nfor the year ended December 31, 2025, and our subsequent Quarterly Reports on\nForm 10-Q, each as filed or to be filed with the SEC, and in our other filings\nwith the SEC. The forward-looking statements are applicable only as of the\ndate on which they are made, and we do not assume any obligation to update any\nforward-looking statements, except as may be required by law.\n\nInvestor Contact:\nCamilla Zuckero\nczuckero@castlebiosciences.com (mailto:czuckero@castlebiosciences.com)\n\nMedia Contact:\nAllison Marshall\namarshall@castlebiosciences.com (mailto:amarshall@castlebiosciences.com)\n\nView original content to download\nmultimedia:https://www.prnewswire.com/news-releases/acg-2026-data-show-tissuecypher-identifies-elevated-risk-of-progression-beyond-pathology-findings-in-barretts-esophagus-302905923.html\n(https://www.prnewswire.com/news-releases/acg-2026-data-show-tissuecypher-identifies-elevated-risk-of-progression-beyond-pathology-findings-in-barretts-esophagus-302905923.html)\n\nSOURCE Castle Biosciences, Inc.\n\n\n\nPhoto: \nhttps://mmx.prnewswire.com/media/MS1817330/Castle-Biosciences-Logo.jpg?id=OA3013487\n\nCopyright (c) 2026 PR Newswire Association,LLC. All Rights Reserved.","article_body_html":"","raw_payload":{"data":{"id":"nPn24fqY4a-20261012","title":"ACG 2026 Data Show TissueCypher® Identifies Elevated Risk of Progression Beyond Pathology Findings in Barrett's Esophagus","author":"PR Newswire","ticker":"CSTL","created":"2026-10-12T20:30:00.227Z","tickers":["CSTL"],"exchange":"NASDAQ","article_body":"ACG 2026 Data Show TissueCypher® Identifies Elevated Risk of Progression Beyond Pathology Findings in Barrett's Esophagus\nPR Newswire\n\nFRIENDSWOOD, Texas, Oct. 12, 2026\n\nStudies highlight how molecular risk assessment with TissueCypher can help\ninform surveillance and treatment decisions beyond biopsy findings alone\n\nFRIENDSWOOD, Texas, Oct. 12, 2026 /PRNewswire/ -- Castle Biosciences, Inc.\n(Nasdaq: CSTL), a company improving health through innovative tests that guide\npatient care, today announced that new data from three studies evaluating its\nTissueCypher Barrett's Esophagus (BE) test will be presented at the American\nCollege of Gastroenterology (ACG) 2026 Annual Scientific Meeting and\nPostgraduate Course, taking place Oct. 9-14 in Nashville, Tennessee. The\nstudies include two case reports and one multi-center study highlighting how\nTissueCypher can provide additional risk information beyond histopathology to\nsupport risk-aligned patient management decisions.\n\n\"Endoscopic biopsy findings do not always tell the whole story when it comes\nto a patient's risk of progression,\" said study author Virendra Joshi, M.D.,\nFAGA, FACG, board-certified gastroenterologist and associate professor in the\nDivision of Digestive Diseases in the Department of Medicine at Emory\nUniversity School of Medicine in Atlanta. \"The studies being presented at ACG\ndemonstrate how TissueCypher can complement standard pathology by providing\nobjective molecular risk information that helps guide surveillance and\ntreatment decisions for patients with Barrett's esophagus, particularly when a\npatient's molecular risk suggests a different approach than their biopsy\ndiagnosis alone would indicate.\"\n\nBE is a precancerous condition associated with an increased risk of esophageal\nadenocarcinoma (EAC), yet biopsy findings alone do not always accurately\nreflect a patient's individual biological risk of progression. TissueCypher\nanalyzes protein biomarkers and tissue architecture in routine endoscopic\nbiopsy samples to provide an individualized five-year probability of\nprogression to high-grade dysplasia (HGD) or EAC.\n\nStudy findings and presentation details are included below. All posters will\nbe presented in Exhibit Halls A-D (Level 3) at Music City Center.\n\nP3056: The Tissue Systems Pathology Test Enabled Detection of Missed Prevalent\nDysplasia in a Presumed Clinically Low-Risk Patient With Non-Dysplastic\nBarrett's Esophagus\n\n * Presenting author: Salih Samo, M.D., University of Kansas School of Medicine\n * Date and Time: Monday, Oct. 12; 10:30 a.m.-4:15 p.m. Central time\n * Key findings: According to gastroenterology society guidelines, patients\ndiagnosed with non-dysplastic BE (NDBE) are generally recommended to undergo\nsurveillance endoscopy every three to five years because they are considered\nat relatively low risk of progression. However, biopsy findings alone may not\nfully reflect a patient's underlying biological risk, and some patients may\nharbor advanced precancerous changes that cannot be detected through routine\nhistopathologic assessment alone. In this case report, TissueCypher returned a\nhigh-risk result for a patient with NDBE, indicating a 62% probability of\nprogression to HGD or EAC within five years. The result informed a risk-based\nmanagement approach and led to a repeat endoscopy six months after the initial\nexamination, at which previously missed prevalent HGD was identified. The\npatient subsequently underwent endoscopic eradication therapy (EET) with\nradiofrequency ablation (RFA). This case illustrates how TissueCypher may help\nidentify elevated risk among patients with an NDBE diagnosis, helping\nclinicians identify patients who may benefit from earlier evaluation and\nintervention than would otherwise be recommended based on histology alone.\nP5192: Real-World Impact of Tissue Systems Pathology Test on Barrett's\nEsophagus Management: A Multi-Center Cohort Study\n\n * Presenting author: Shree Patel, M.D., Emory University School of Medicine\n * Date and Time: Tuesday, Oct. 13; 10:30 a.m.-4 p.m. Central time\n * Key findings: Histopathology and clinical factors alone may not fully\nidentify which patients with BE are at elevated risk of progression to\nHGD/EAC. In the study, molecular risk stratification using TissueCypher was\ncompared with the Progression in Barrett's (PIB) clinicopathologic-based risk\nstratification approach. There was only slight agreement between the two\napproaches (Cohen's κ = 0.04). TissueCypher classified 83% of patients as low\nrisk and 17% as intermediate/high risk, whereas the PIB score classified 31%\nof patients as low risk and 69% as intermediate/high risk. Following\nTissueCypher testing, management recommendations were changed in a manner\nconsistent with the test's risk classification for 96% of patients in this\ncohort, suggesting that the results informed clinical decision-making in this\nstudy population. Under guideline-informed management, most patients would\nhave been recommended surveillance every three years using the PIB approach.\nHowever, guided by TissueCypher results, physicians recommended a longer\nfive-year surveillance window for 38 patients and EET for eight, which\nincluded five patients with NDBE whose TissueCypher results indicated\nintermediate or high risk or progression despite having no dysplasia detected\non their biopsy. These findings suggest that TissueCypher may provide\nadditional risk information beyond clinicopathologic assessment to support\nmore individualized surveillance and treatment recommendations.\nP5296: The Tissue Systems Pathology Test Facilitated Early Intervention in a\nHistopathologically Complex Case of Barrett's Esophagus\n\n * Presenting author: Shree Patel, M.D., Emory University School of Medicine\n * Date and Time: Tuesday, Oct. 13; 10:30 a.m.-4 p.m. Central time\n * Key findings: Conflicting biopsy results can make it difficult to determine\nthe appropriate management strategy for patients with BE. In this case, a\npatient's biopsies were successively classified as NDBE, low-grade dysplasia\n(LGD) and indefinite for dysplasia (IND), creating uncertainty about the\npatient's risk and management plan. TissueCypher testing of the IND biopsy\nreturned a high-risk result, indicating a 47% probability of progression to\nHGD or EAC within five years. The high-risk result prompted an interventional\nendoscopy with RFA two months after the endoscopy that yielded the IND\ndiagnosis. Biopsies obtained during the procedure confirmed previously\nundetected HGD, consistent with the TissueCypher high-risk classification.\nFollowing RFA and subsequent cryotherapy, follow-up biopsies confirmed\ncomplete eradication of the patient's intestinal metaplasia. This case\nillustrates how TissueCypher may help reduce uncertainty for patients with\ninconclusive or discordant biopsy findings by providing objective risk\ninformation that supports timely intervention and individualized patient\nmanagement.\nTissueCypher Product Theater\n\n * Date and Time: Tuesday, Oct. 13; 1:15-1:45 p.m. Central time\n * Location: Product Theater Area (Booth 117)\n * Castle will host a product theater titled, \"Low-risk on histology. High-risk\nin reality: Johnny Walker's journey with Barrett's esophagus.\" During the\nsession, TissueCypher patient ambassador Johnny Walker will join Mark\nAmorosino, M.D., gastroenterologist at Gastro Health, and David Forcione,\nM.D., advanced endoscopist at Baptist Health, to discuss how TissueCypher's\nmolecular risk assessment provided additional insight beyond his NDBE\ndiagnosis and informed treatment decisions that ultimately led to the\ndetection of dysplasia.\nFor more information on TissueCypher, visit Castle at Booth 1706.\n\nAbout TissueCypher Barrett's Esophagus Test\nTissueCypher is a precision medicine test designed and extensively validated\nto predict a patient's personalized risk of progression from Barrett's\nesophagus (BE) to high-grade dysplasia (HGD) or esophageal adenocarcinoma\n(EAC). Indicated for patients with non-dysplastic BE, indefinite for dysplasia\nor with low-grade dysplasia, TissueCypher's five-year risk assessment is\ndesigned to help physicians tailor care to each patient's risk of developing\nHGD or EAC.\n\nBacked by more than 17 peer-reviewed publications and studied in biopsies\nfrom more than 8,000 patients, TissueCypher has been shown to be the strongest\nindependent predictor of progression compared with traditional\nhistopathological risk assessment. Using an AI-derived spatialomics approach,\nthe test identifies molecular signatures that often precede the development of\ndysplasia, which can enable earlier identification, treatment, and management\nof patients at increased risk of cancer. TissueCypher is designed to integrate\nseamlessly into routine endoscopic practice by analyzing standard esophageal\npinch biopsies, delivering actionable insights without requiring additional\nprocedures. Learn more at CastleBiosciences.com/TissueCypher\n(https://edge.prnewswire.com/c/link/?t=0&l=en&o=4795731-1&h=3094218765&u=https%3A%2F%2Fedge.prnewswire.com%2Fc%2Flink%2F%3Ft%3D0%26l%3Den%26o%3D4711582-1%26h%3D3125422294%26u%3Dhttp%253A%252F%252Fcastlebiosciences.com%252Ftissuecypher%26a%3DCastleBiosciences.com%252FTissueCypher&a=CastleBiosciences.com%2FTissueCypher)\n.\n\nAbout Castle Biosciences\nCastle Biosciences (Nasdaq: CSTL) is a leading diagnostics company improving\nhealth through innovative tests that guide patient care. With a primary focus\nin dermatologic and gastroenterological disease, we develop personalized,\nclinically actionable solutions that help improve disease management and\npatient outcomes.\n\nWe put people first—empowering patients and clinicians and informing care\ndecisions through rigorous science and advanced molecular tests that support\nmore confident treatment planning. To learn more,\nvisit www.CastleBiosciences.com\n(https://edge.prnewswire.com/c/link/?t=0&l=en&o=4795731-1&h=3620373660&u=http%3A%2F%2Fwww.castlebiosciences.com%2F&a=www.CastleBiosciences.com)\n and connect with us on LinkedIn\n(https://edge.prnewswire.com/c/link/?t=0&l=en&o=4795731-1&h=3797892228&u=https%3A%2F%2Fwww.linkedin.com%2Fcompany%2Fcastle-biosciences-inc-%2F&a=LinkedIn)\n, Instagram\n(https://edge.prnewswire.com/c/link/?t=0&l=en&o=4795731-1&h=1175666527&u=https%3A%2F%2Fwww.instagram.com%2Fcastlebiosciences%2F&a=Instagram)\n, Facebook\n(https://edge.prnewswire.com/c/link/?t=0&l=en&o=4795731-1&h=29659263&u=https%3A%2F%2Fwww.facebook.com%2Fcastlebiosciences%2F&a=Facebook)\n and X\n(https://edge.prnewswire.com/c/link/?t=0&l=en&o=4795731-1&h=3962974639&u=https%3A%2F%2Ftwitter.com%2Fcastlebio%3Flang%3Den&a=X)\n. \n\nDecisionDx-Melanoma, DecisionDx-CMSeq, i31-SLNB, i31-ROR, DecisionDx-SCC,\nMyPath Melanoma, AdvanceAD-Tx, TissueCypher, Esopredict, DecisionDx-UM,\nDecisionDx-PRAME and DecisionDx-UMSeq are trademarks of Castle Biosciences,\nInc.\n\nForward-Looking Statements\nThis press release contains forward-looking statements within the meaning of\nSection 27A of the Securities Act of 1933, as amended, and Section 21E of the\nSecurities Exchange Act of 1934, as amended, which are subject to the \"safe\nharbor\" created by those sections. These forward-looking statements include,\nbut are not limited to, statements concerning: TissueCypher's ability to (i)\npredict a patient's personalized risk of progression from Barrett's esophagus\nto high-grade dysplasia or esophageal adenocarcinoma, (ii) help clinicians\ntailor surveillance and management decisions to each patient's individual risk\nprofile, (iii) enable earlier identification and management of patients at\nincreased risk of cancer, (iv) help reduce uncertainty for patients, and (v)\nperform favorably as compared with traditional histopathological risk\nassessment and integrate into routine clinical workflows. The words \"believe,\"\n\"can,\" \"may\" and similar expressions are intended to identify forward-looking\nstatements, although not all forward-looking statements contain these\nidentifying words. We may not actually achieve the plans, intentions or\nexpectations disclosed in our forward-looking statements, and you should not\nplace undue reliance on our forward-looking statements. Actual results or\nevents could differ materially from the plans, intentions and expectations\ndisclosed in the forward-looking statements that we make. These\nforward-looking statements involve risks and uncertainties that could cause\nour actual results to differ materially from those in the forward-looking\nstatements, including, without limitation: subsequent study or trial results\nand findings may contradict earlier study or trial results and findings or may\nnot support the results obtained in these studies, including with respect to\nthe discussion of our tests in this press release; actual application of our\ntests may not provide the aforementioned benefits to patients; and the risks\nset forth under the heading \"Risk Factors\" in our Annual Report on Form 10-K\nfor the year ended December 31, 2025, and our subsequent Quarterly Reports on\nForm 10-Q, each as filed or to be filed with the SEC, and in our other filings\nwith the SEC. The forward-looking statements are applicable only as of the\ndate on which they are made, and we do not assume any obligation to update any\nforward-looking statements, except as may be required by law.\n\nInvestor Contact:\nCamilla Zuckero\nczuckero@castlebiosciences.com (mailto:czuckero@castlebiosciences.com)\n\nMedia Contact:\nAllison Marshall\namarshall@castlebiosciences.com (mailto:amarshall@castlebiosciences.com)\n\nView original content to download\nmultimedia:https://www.prnewswire.com/news-releases/acg-2026-data-show-tissuecypher-identifies-elevated-risk-of-progression-beyond-pathology-findings-in-barretts-esophagus-302905923.html\n(https://www.prnewswire.com/news-releases/acg-2026-data-show-tissuecypher-identifies-elevated-risk-of-progression-beyond-pathology-findings-in-barretts-esophagus-302905923.html)\n\nSOURCE Castle Biosciences, Inc.\n\n\n\nPhoto: \nhttps://mmx.prnewswire.com/media/MS1817330/Castle-Biosciences-Logo.jpg?id=OA3013487\n\nCopyright (c) 2026 PR Newswire Association,LLC. All Rights Reserved."},"type":"article","timestamp":"2026-10-12T20:30:00.272223925Z","server_sent_at_ms":1791837000272},"received_at":"2026-10-12T20:30:00.419Z","source_url":"https://www.prnewswire.com/news-releases/acg-2026-data-show-tissuecypher-identifies-elevated-risk-of-progression-beyond-pathology-findings-in-barretts-esophagus-302905923.html"},"analysis":{"id":"155161","press_release_id":"166818","analysis_json":{"industry":{"label":"Health Care Providers & Services","sector":"Health Care"},"redFlags":[],"eventType":"operations_update","narrative":"Castle Biosciences announced three studies of its TissueCypher Barrett's Esophagus test being presented at the ACG 2026 Annual Scientific Meeting in Nashville.\n\nA multi-center cohort study found TissueCypher results changed management recommendations for 96% of patients, including extending surveillance intervals and prompting endoscopic eradication therapy in patients whose biopsies showed no dysplasia.\n\nTwo case reports showed the test flagged high five-year progression risk (62% and 47%) in patients presumed low-risk on histology, leading to earlier intervention and detection of previously missed high-grade dysplasia.\n\nThe data support TissueCypher's adoption case beyond pathology alone, a modest positive for the commercial narrative though not a near-term financial catalyst.","sentiment":"bullish","agentHooks":{"shouldPost":false,"suggestedAngle":"Real-world ACG data show TissueCypher changes management in 96% of cases -- incremental evidence for guideline expansion."},"keyFigures":{"customDimensions":{"patients_studied":"more than 8,000","cohens_kappa_vs_pib":0.04,"management_change_rate":"96% of multi-center cohort","tissuecypher_risk_split":"83% low risk / 17% intermediate-high risk","peer_reviewed_publications":"more than 17","high_risk_case_1_probability":"62% five-year progression probability","high_risk_case_2_probability":"47% five-year progression probability"}},"quotedText":"Endoscopic biopsy findings do not always tell the whole story when it comes to a patient's risk of progression","namedEntities":{"people":[{"name":"Virendra Joshi","role":"Gastroenterologist, Emory University School of Medicine; study author"},{"name":"Salih Samo","role":"Presenting author, University of Kansas School of Medicine"},{"name":"Shree Patel","role":"Presenting author, Emory University School of Medicine"},{"name":"Mark Amorosino","role":"Gastroenterologist, Gastro Health"},{"name":"David Forcione","role":"Advanced endoscopist, Baptist Health"},{"name":"Johnny Walker","role":"TissueCypher patient ambassador"}],"products":["TissueCypher Barrett's Esophagus test","DecisionDx-Melanoma","Esopredict"],"companies":[{"name":"Castle Biosciences, Inc.","ticker":"CSTL","relationship":"filer"},{"name":"Emory University School of Medicine","relationship":"research collaborator"},{"name":"University of Kansas School of Medicine","relationship":"research collaborator"},{"name":"American College of Gastroenterology","relationship":"conference host"}],"dollarAmounts":[]},"materialImpact":{"score":2,"reasoning":"Conference-poster data supporting commercial adoption of TissueCypher, including real-world evidence that testing changed management for 96% of a cohort. 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