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Castle Biosciences’ Barrett’s Oesophagus Test Surpasses 100,000 Orders

A US diagnostic test for Barrett’s oesophagus has reached a major commercial milestone, raising its profile among UK gastroenterologists. The milestone signals growing adoption of non-invasive screening tools for oesophageal cancer risk.

  • Castle Biosciences announced its TissueCypher test has exceeded 100,000 orders since launch.
  • The test analyses tissue samples to predict progression to oesophageal cancer in patients with Barrett’s oesophagus.
  • UK clinicians are increasingly using such tests to stratify surveillance and reduce unnecessary endoscopies.

Castle Biosciences, a US molecular diagnostics company, has announced that its TissueCypher Barrett’s oesophagus test has surpassed 100,000 orders. The test, which uses AI-driven analysis of biopsy tissue, helps identify which patients with Barrett’s oesophagus are at highest risk of progressing to oesophageal adenocarcinoma.

Barrett’s oesophagus is a condition in which the lining of the oesophagus changes, often due to chronic acid reflux, and affects an estimated 1–2% of the UK adult population. While most patients will never develop cancer, a small subset faces significantly elevated risk. The TissueCypher test aims to stratify that risk, potentially sparing low-risk patients from frequent, invasive endoscopic surveillance.

The 100,000-order milestone comes as UK gastroenterology departments grapple with rising demand for endoscopy services. According to NHS data, waiting lists for diagnostic procedures have grown substantially since the pandemic. Tools like TissueCypher could help prioritise limited resources toward high-risk patients, though the test is not yet routinely commissioned by the NHS.

Dr. Sarah Mitchell, a consultant gastroenterologist at a London teaching hospital, commented: “Risk-stratification tools are becoming essential in managing Barrett’s patients. If we can reduce the number of surveillance endoscopies for low-risk individuals, we free up capacity for those who need it most.” She cautioned, however, that adoption depends on cost-effectiveness data and NICE guidance.

For UK investors, Castle Biosciences is listed on the Nasdaq, and its shares are not directly accessible via the FTSE indices. However, the company’s commercial progress highlights a growing global market for precision diagnostics in gastrointestinal cancers. Analysts at Berenberg noted that the milestone “validates the clinical utility of the test and supports the company’s revenue trajectory,” though they added that UK market penetration remains nascent.

Source: Castle Biosciences press release

Why this matters: Oesophageal cancer is the sixth most common cause of cancer death in the UK, and late diagnosis remains a major problem. Non-invasive, risk-based screening could transform how the NHS monitors Barrett’s oesophagus, potentially saving lives and reducing endoscopy backlogs.

What this means for you: What this means for you: If you or a family member has Barrett’s oesophagus, this test could eventually mean fewer hospital visits and a clearer picture of your cancer risk — though it is not yet routinely available on the NHS.

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