This discussion revolves around the observation that there seems to be a higher number of ostomy patients from the UK compared to the USA, especially on online platforms. The originator is curious about why this might be the case, considering the UK's smaller population. Here are some insights and advice shared by participants:

1. **Cancer Statistics**: The UK ranks 24th in colorectal cancer incidence, while the USA is not in the top 25, suggesting cancer rates alone don't explain the difference in ostomy numbers.

2. **Medication Access**: In the USA, access to expensive medications like steroids and biologics might prevent some from needing surgery. In contrast, UK patients might undergo surgery sooner if such drugs are less accessible through the NHS.

3. **Dating Site Observations**: There appears to be a higher per capita number of female ostomates in the UK compared to the USA, raising questions about this discrepancy.

4. **Dietary Factors**: Some members blame Western diets, including processed meats and high-fat foods, for bowel diseases leading to ostomies. These diseases are reportedly less common in non-Western regions.

5. **Healthcare Systems**:
- The UK's NHS provides universal coverage, encouraging early diagnosis and timely surgery, which might result in more living ostomates.
- The US healthcare system, with its high costs and uneven insurance coverage, might delay diagnosis or make surgery unaffordable, potentially reducing the visible ostomate population.
- Temporary ostomies in the US might also contribute to fewer long-term ostomates on forums.

6. **Drug Costs and Access**:
- In England, the NHS negotiates drug prices, making prescriptions affordable, though some new drugs are rationed.
- US insurers may cover expensive biologics, possibly preventing surgeries, but these drugs can be much more expensive.

7. **Historical and Professional Influence**: The UK has a history of expertise in ostomy techniques, possibly due to early advancements by surgeons like Professor Bryan Brooke.

8. **Sampling and Website Bias**: UK-based sites naturally have more UK users, and English-speaking forums often see more participation from the UK, Canada, and Australia.

9. **Data Gaps**: There is a noted lack of comprehensive statistics on ostomy prevalence by country, with requests for reliable data sources.

10. **Personal Experiences**: Some find dating easier with fellow ostomates due to shared understanding of related issues, while others suggest that many people are accepting once informed.

These points reflect a mix of healthcare, cultural, and personal factors that might contribute to the observed differences in ostomy prevalence between the UK and the USA.