FIT kit-dispensing kiosk to promote uptake of CRC screening in SG

An automated kiosk that dispenses faecal immunochemical test (FIT) kits, called the KIPFIT*, has the potential to increase colorectal (CRC) screening uptake in Singapore, as shown in a study.

KIPFIT was able to increase accessibility of the stool-based test to the target population, with a screening participation rate of 58.3 percent and screening completion rate of 68.9 percent. [Sci Rep 2025;15:37203]

The numbers represent an improvement from the reported 27.3 percent of individuals who underwent CRC screening in the Singapore Community Health Study, according to the investigators. [Front Oncol 2021;11:684917]

KIPFIT dispenses two FIT kits and return envelopes to individuals with average risks of CRC. The tests can be completed at home and are mailed to the laboratory using the preaddressed envelopes. Printed instructions and QR links to video instructions—which are provided in English and Chinese—for proper use of the kits are enclosed in the same package as the kits.

Such an approach overcomes logistic barriers to CRC screening by providing round-the-clock access to the necessary testing kits. “Mailing the completed FIT kits free of charge or dropping them off at collection points helps to close the loop,” the investigators said.

The goal is to scale KIPFIT up in the community, deploying the kiosk across public housing estates or even at primary healthcare clinic locations.

“Primary healthcare professionals can easily direct target persons to the nearest kiosks once a network is established for increased productivity of staff (when patient self-serves) and consolidation of stocks in the locality (less individual administrative work needed),” the investigators said.

Screening completion factors

For the study, the investigators set up a KIPFIT prototype at a multi-purpose community mall. Next to the kiosk was a booth, where clinical research coordinators approached adults in the vicinity and screened them for participation eligibility.

A total of 350 eligible adults (average age 66.1 years, 57.4 percent female, 91.4 percent Chinese, 49.7 percent had less than 10 years of education) consented to use the kiosk and were recruited. Of these, 241 (68.9 percent) mailed at least one kit to the laboratory within 2 months, with 21 (8.7 percent) having one positive test result.

Screening completion rate was much higher among those with self-reported awareness of screening tests for CRC vs those who lacked such awareness (73.6 percent vs 51.4 percent) and among those who had prior CRC screening by either stool-based test or colonoscopy vs those who had never undergone screening (74.8 percent vs 56.9 percent).

In a multivariable analysis, the odds of mailing the test kits were two-to-threefold higher among Chinese participants (adjusted odds ratio [aOR], 3.13, 95 percent confidence interval [CI], 1.42–6.9; p=0.005) and those with self-reported awareness of screening tests for CRC (aOR, 2.18, 95 percent CI, 1.1–4.33; p=0.026).

Usability challenges

KIPFIT requires its users to first register in the Singapore Cancer Society web portal through their mobile phones. Upon successful registration, the users receive a unique Redemption QR code. This code is then scanned at the kiosk’s scanner to facilitate dispensing of the FIT kits, which are collected at the opening at the bottom of the kiosk.

The perceived usability of KIPFIT was assessed using the System Usability Scale (SUS), with higher scores indicating better usability and a score of 68 marking the threshold for average level of usability. KIPFIT had an SUS score of 57.7, which was lower than the benchmark, reflecting usability challenges for certain users.

About one in seven participants (14.9 percent) found the kiosk “unnecessarily complex,” and one in three (34.3 percent) indicated that they might need help from support personnel to use the kiosk. SUS scores tended to be lower among older participants and higher among those with higher education. When stratified by education level, lower SUS scores came from women and older participants in the subgroup with lower education and from older participants only in the subgroup with higher education.

Nevertheless, most participants deemed that “the kiosk was easy to use” (62.3 percent), believed that “most people would learn to use the kiosk very quickly” (57.4 percent), and expressed that they would use the kiosk to collect the FIT kits in the future (68.6 percent).

“The KIPFIT kiosk is the first prototype, and technical enhancement is expected before it is scaled up for deployment in the community,” the investigators said.

They also emphasized that the kiosk is not intended to replace the modality of CRC screening in primary care but rather complement the existing CRC screening programme via distribution of the FIT kits from healthcare providers and community pharmacy.

“Hence the target population for CRC screening who are older, female, and had lower education level should continue to leverage on existing healthcare system to collect the FIT kits if they find challenges and difficulties in using the kiosk on their own. The kiosk provides another access option of obtaining the FIT kits, so that the overall CRC screening rate can be augmented,” the investigators pointed out.

Next steps

Features such as digitalized education material (eg, video demonstrating the procedure of FIT kit collection) and technical support will be introduced in KIPFIT before its deployment as a standalone kiosk, according to the investigators.

They hoped that the results of the study would help move the KIPFIT from an experimental device to a practical component of public health infrastructure.

“KIPFIT kiosks can potentially be adapted to expand CRC screening outreach to communities beyond Singapore, especially those living in densely populated urban environment. Concurrently, publicity should be stepped up to raise the awareness of the public, especially those in the target population, on preventive health, cancer screening, and the purpose of the kiosk,” the investigators said.

*Kiosk to Promote Faecal Immunochemical Testing