On this page of StockholderLetter.com we present the latest annual shareholder letter from CASTLE BIOSCIENCES INC — ticker symbol CSTL. Reading current and past CSTL letters to shareholders can bring important insights into the investment thesis.
20 24 ANNUAL REPORT
Dear Fellow Stockholders, 2024 was another year of strength for Castle. Fueled by our steadfast commitment to improving patient care, we navigated a dynamic reimbursement and regulatory landscape while delivering exceptional performance results for our stockholders. Our team's unwavering passion and collaborative spirit were instrumental in driving us forward, underscoring our strong, people- culture and powers our organization. 2023. Importantly, we believe providers due to the meaningful impact we are making in the lives of patients through our tests that can help improve treatment pathway decisions and, ultimately, outcomes. Empowering people, informing care decisions Ongoing evidence development is a key strategic priority at Castle and an important factor contributing to the continued adoption of our tests. In our dermatologic portfolio, " " -Melanoma and DecisionDx -SCC tests for patients with skin cancers, we delivered new data demonstrating the clinical value of our tests in guiding treatment pathway decisions. For DecisionDx-Melanoma, we shared impactful new data from our prospective, multi-center DECIDE study the strength of the test to accurately identify patients with melanoma who have a low risk of metastasis and can thus safely forgo sentinel lymph node biopsy (SLNB) without experiencing a recurrence. As the only melanoma prognostic test shown to be associated with improved patient survival, this new data reinforces the meaningfully contribute to improved standards of care through more informed and personalized decision-making for patients with melanoma. Regarding DecisionDx-SCC, our test for patients with high-risk squamous cell carcinoma (SCC), numerous published studies in 2024 he use of our test to predict which patients diagnosed adjuvant radiation therapy (ART) from ART. i -center studies published in 2024 represent the largest and the second In our gastroenterology portfolio, we achieved yet another , surpassing 25,000 TissueCypher test reports delivered since Castle acquired the test We have seen impressive growth and adoption of this test year after year, which we believe is driven by the tremendous value the test provides in predicting a Barrett s esophagus patient s risk of developing esophageal cancer. This actionable information helps clinicians make more informed decisions with their patients about appropriate surveillance and treatment interventions aligned to their personal estimated risk of disease progression. Looking Forward Throughout 2024, the unwavering commitment and passion of our exceptional Castle team helped us improve the care of thousands of patients, propelling us toward our vision of transforming disease management by keeping . what we believe is strength and are energized by the numerous opportunities to further our impact and deliver long-term value for our stockholders. On behalf of the entire Castle team, thank you for your continued trust in Castle. Sincerely, Derek Maetzold Founder, President & CEO
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CSTL Shareholder/Stockholder Letter Transcript:

20
24
ANNUAL
REPORT


Dear Fellow Stockholders,
2024 was another year of strength for Castle. Fueled by our steadfast commitment to improving patient care, we
navigated a dynamic reimbursement and regulatory landscape while delivering exceptional performance results
for our stockholders. Our team's unwavering passion and collaborative spirit were instrumental in driving us
forward, underscoring our strong, people-                                                            culture and powers our organization.

2023. Importantly, we believe                                                                                                                                                                         
providers due to the meaningful impact we are making in the lives of patients through our tests that can help
improve treatment pathway decisions and, ultimately, outcomes.
Empowering people, informing care decisions
Ongoing evidence development is a key strategic priority at Castle and an important factor contributing to the
continued adoption of our tests. In our dermatologic portfolio,                                 "              "    -Melanoma and
DecisionDx  -SCC tests for patients with skin cancers, we delivered new data demonstrating the                       clinical
value of our tests in guiding treatment pathway decisions.
For DecisionDx-Melanoma, we shared impactful new data from our prospective, multi-center DECIDE study
                   the strength of the test to accurately identify patients with melanoma who have a low risk of metastasis
and can thus safely forgo sentinel lymph node biopsy (SLNB) without experiencing a recurrence. As the only
melanoma prognostic test shown to be associated with improved patient survival, this new data reinforces the
                                                          meaningfully contribute to improved standards of care through more informed and
personalized decision-making for patients with melanoma.
Regarding DecisionDx-SCC, our test for patients with high-risk squamous cell carcinoma (SCC), numerous
published studies in 2024                                                           he use of our test to predict which patients diagnosed
                                                                                            adjuvant radiation therapy (ART)                                                                             
from ART. i                                                        -center studies published in 2024 represent the largest and the second
In our gastroenterology portfolio, we achieved yet another                                         , surpassing 25,000 TissueCypher  
test reports delivered since Castle acquired the test                                         We have seen impressive growth and
adoption of this test year after year, which we believe is driven by the tremendous value the test provides in
predicting a Barrett   s esophagus patient   s risk of developing esophageal cancer. This actionable information helps
clinicians make more informed decisions with their patients about appropriate surveillance and treatment
interventions aligned to their personal estimated risk of disease progression.
Looking Forward
Throughout 2024, the unwavering commitment and passion of our exceptional Castle team helped us improve the
care of thousands of patients, propelling us toward our vision of transforming disease management by keeping
                      .                                                                             what we believe is                                                                               
strength and are energized by the numerous opportunities to further our impact and deliver long-term value for our
stockholders. On behalf of the entire Castle team, thank you for your continued trust in Castle.
Sincerely,
Derek Maetzold
Founder, President & CEO




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