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However, whether increased spending has translated into measurable population\u2010level improvements in cancer outcomes remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective ecological time\u2010series analysis using national data from 2008 to 2023. Public expenditures for female breast and prostate cancer were extracted from DATASUS and inflation\u2010adjusted, while mortality data were obtained from INCA and age\u2010standardized. Key policy milestones\u2014RDC 55\/2010, creation of Conitec in 2011, Ordinance No. 874\/2013, and Constitutional Amendment 95\/2016\u2014were mapped against expenditure and mortality trends. Findings therefore represent system\u2010level associations rather than causal estimates of patient\u2010level therapeutic effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Oncology expenditures increased substantially, with more pronounced growth after 2011, whereas national age\u2010standardized mortality rates for female breast and prostate cancer changed comparatively little. This pattern represents a descriptive temporal divergence between expenditure growth and mortality trends, not evidence of therapeutic inefficacy or a quantified causal effect. Regional differences in diagnostic capacity, healthcare infrastructure, continuity of care, and treatment timeliness may influence how financial inputs translate into population\u2010level outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Brazil's experience supports a value\u2010oriented oncology strategy linking investment not only to technology incorporation, but also to early diagnosis, implementation capacity, regional equity, and effective care pathways. These ecological findings do not support individual\u2010level causal inference, particularly for prostate cancer, for which mortality is a delayed and relatively insensitive medium\u2010term endpoint. Future studies should incorporate stage at diagnosis, treatment pathways, time\u2010to\u2010treatment indicators, and regional survival data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72221","type":"journal-article","created":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T04:33:07Z","timestamp":1788582787000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cancer Expenditures and Mortality Trends in Brazil: An Ecological Population\u2010Level Time\u2010Series Analysis, 2008\u20132023"],"prefix":"10.1002","volume":"15","author":[{"given":"Larissa Saldanha","family":"Fonseca","sequence":"first","affiliation":[{"name":"Laboratory of Nanoradiopharmacy and Synthesis of New Radiopharmaceuticals Brazilian Nuclear Energy Commission, Nuclear Engineering Institute  Rio de Janeiro RJ Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo Paredes","family":"Pires","sequence":"additional","affiliation":[{"name":"Laboratory of Nanoradiopharmacy and Synthesis of New Radiopharmaceuticals Brazilian Nuclear Energy Commission, Nuclear Engineering Institute  Rio de Janeiro RJ Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8210-2016","authenticated-orcid":false,"given":"Luciana Magalh\u00e3es Rebelo","family":"Alencar","sequence":"additional","affiliation":[{"name":"Department of Physics Biophysics and Nanosystems Laboratory, Federal University of Maranh\u00e3o  S\u00e3o Luis MA Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2550-696X","authenticated-orcid":false,"given":"Eduardo","family":"Ricci\u2010Junior","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Federal University of Rio de Janeiro  Rio de Janeiro RJ Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0905-481X","authenticated-orcid":false,"given":"Ralph","family":"Santos\u2010Oliveira","sequence":"additional","affiliation":[{"name":"Laboratory of Nanoradiopharmacy and Synthesis of New Radiopharmaceuticals Brazilian Nuclear Energy Commission, Nuclear Engineering Institute  Rio de Janeiro RJ Brazil"},{"name":"Laboratory of Radiopharmacy and Nanoradiopharmaceuticals Rio de Janeiro State University  Rio de Janeiro RJ Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"e_1_2_12_2_1","first-page":"207","article-title":"Death From Cancer and Cardiovascular Disease Between Two Brazils","volume":"114","author":"Martins S. 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