I encountered this too and when I dug deeper and added Country as a secondary dimension I discovered that 72% of my en-us visitors ARE in the UK... only 11% are from the USA.
This suggests that those 72% have the wrong locale set on whatever device/PC/etc they are using to visit my site.
I suspect misconfigured home, corporate and internet cafe computers/devices may have something to do with this - when installing Windows you have to set the locale correctly in 3 different places and this is rarely done correctly.
In any case you should NOT infer location from language - though often correlated one does not imply the other and if you were to assume so many users could be inconvenienced.
Instead, either use IP lookup, HTML5 geolocation or request that the user selects their location - which should always be provided anyway (and prominently) to allow override in case one of the other methods results in an incorrect/inappropriate location.