To explore the clinical characteristics of patients with non-hereditary colorectal polyp disease and investigate the risk factors associated with polyp recurrence.

A total of 442 patients with non-hereditary colorectal polyp disease who underwent endoscopic resection from January 2021 to December 2023 were selected. Clinical data and colonoscopy monitoring results within one year post-resection were collected to analyze the influencing factors of polyp recurrence.

The mean age of patients at initial colonoscopy was (56.63±10.71) years, with 241 males (54.52%) and a BMI of (23.25±3.35) kg/m². During the 1-year follow-up, a total of 90 patients (20.36%) experienced recurrence. Compared with the non-recurrence group, the recurrence group had older age (t=2.290, P=0.023), higher BMI (t=2.550, P=0.011), higher triglyceride (TG) levels (t=2.558, P=0.011), a higher proportion of males (χ²=10.915, P=0.001), a higher proportion of smokers (χ²=9.919, P=0.002), a higher proportion of dyslipidemia (χ²=11.256, P=0.001), lower high-density lipoprotein(HDL) levels (t=2.285, P=0.023), and a higher TG/HDL (t=6.473, P＜0.001). There were significant differences between the recurrence and non-recurrence groups in the stratification of maximum polyp diameter, polyp number, and pathological type of polyps (χ²=6.345, 19.390, and 14.484; P=0.042, ＜0.001, and 0.002, respectively). The recurrence group had higher proportions of patients with a maximum polyp diameter＞15 mm, polyp number＞10, and tubulovillous adenoma. Stratified analysis showed that among patients with hyperplastic polyps, the recurrence group had higher TG levels (t=3.092, P=0.007) and TG/HDL ratio (t=4.041, P=0.001); among patients with tubulovillous adenomas, the recurrence group had higher TG levels (t=4.254, P＜0.001) and TG/HDL ratio (t=5.102, P＜0.001) and lower HDL levels (t=−2.391, P=0.020). Multivariate logistic regression analysis revealed that male sex (OR=5.426, P=0.010), smoking (OR=6.945, P=0.004), maximum polyp diameter＞15 mm (OR=7.574, P=0.013), polyp number＞10 (OR=9.152, P=0.019), and elevated TG (OR=4.444, P=0.018) were independent risk factors for polyp recurrence.

The 1 year polyp recurrence rate after endoscopic resection in patients with non hereditary colorectal polyposis was 20.36%. Male sex, smoking, a maximum polyp diameter ＞15 mm, a polyp number ＞10, and elevated TG were independent risk factors for polyp recurrence. Clinically, enhanced postoperative colonoscopic surveillance and intervention for metabolic risk factors should be implemented in patients with the above characteristics.