The incidence of cancer increases with age in humans and in laboratory animals alike. There are different patterns of age-related distribution of tumors in different organs and tissues. Aging may increase or decrease the susceptibility of various tissues to initiation of carcinogenesis and usually facilitates promotion and progression of carcinogenesis. Aging may predispose to cancer in two ways: tissue accumulation of cells in late stages of carcinogenesis and alterations in internal homeostasis, in particular, alterations in immune and endocrine systems. Increased susceptibility to the effects of tumor promoters is found both in aged animals and aged humans, as predicted by the multistage model of carcinogenesis. Aging is associated with a number of events at the molecular, cellular and physiological levels that influence carcinogenesis and subsequent cancer growth. An improved understanding of age-associated variables impacting on the tumor microenvironment, as well as the cancer cells themselves, will result in improved treatment modalities in geriatric oncology.