The aims of this multiple PI grant are to: 1) Evaluate patterns of medical imaging (utilization and radiation dose) and estimate cumulative exposure to ionizing radiation from medical imaging in a) children (0-18 years old) and b) pregnant women, from 1996-2016; 2) Determine the risk of childhood leukemia among children and adolescents following exposure to all medical imaging examinations that deliver ionizing radiation from 1996-2016 and followed through 2017. We will also examine effects due to exposure from CT exams alone; 3) Determine the risk of childhood cancers among children and adolescents following fetal, in utero (maternal pregnancy) exposure to medical imaging from 1996-2016 followed through 2017; 4) In the subset of the population with complete information during in utero and child or adolescent exposure to medical imaging, assess the cumulative impact of these exposures on childhood cancers.