The concept of geriatric oncology came from precursors in the USA and Italy in the late 80th. But it was developed in practice in France from the early 2000th. When the French National Cancer institute was settled, geriatric oncology was considered as a priority and then, financed on the base of the experience of different French physicians and institutions. Rapidly, geriatric oncology programs were implemented and became a national network including oversea regions. Their objectives were: patients' management, research, teaching, and professional and patients' information. An ambitious research trial allowed to validate the G8 screening tool of frailty. Then, France became a pioneer, participating in the international programs within the framework of the Société internationale d'oncologie gériatrique. Nevertheless, there are still important challenges to implement worldwide geriatric oncology activity and to define precisely decision-making processes.