Multi-institutional 10-year retrospective review of amoeba diagnosed on cytologic evaluation of anal pap tests: what is the significance?

•Anal Pap tests are integral in the surveillance for cancer in high-risk populations such as men who have sex with men (MSM). While this is the main use of anal Pap tests, various infections including intestinal amoeba can be identified. Despite this, there is a paucity of literature regarding the detection of amoeba on anal Pap tests.•In this 10-year, multi-institutional retrospective study, we describe the experience of 2 large academic medical centers with the detection of amoeba on anal Pap tests with investigation into the clinical significance of this finding.•A total of 46 cases were identified between the 2 sites. The vast majority were from MSM (94.8%) without recent history of travel. The majority of patients were asymptomatic (87.0%).•On follow-up, the majority of cases were not further characterized by microbiology studies (89.1%) and the vast majority of patients were not treated (93.5%). These findings question the clinical significance of this cytologic finding.