Malignant pleural mesothelioma (MPM) is a rare and aggressive neoplasm. Patients are usually diagnosed when current treatments have limited benefits, highlighting the need for non-invasive tests aiming at an early MPM diagnosis and prognostic tool that might improve life expectancy. The evaluation of asbestos exposure was conducted considering the frequency, the duration and the intensity of occupational, environmental and domestic exposure. Genome-wide methylation array to identify novel blood DNA methylation markers of MPM was used. The roles of epigenetic age acceleration measures and lymphocyte-to-monocyte ratio were also investigated. Using advanced statistical modeling, our results suggest the potential application of DNAm profiles, considering age acceleration measures and LMR in blood to develop non-invasive tests for MPM detection in asbestos-exposed subjects and for prognostic evaluation in MPM. A large-scale prospective validation study is still needed to properly validate these results. ukryj opis